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Pacemaker Implantation Associated Myocardial Micro-Damage: A Randomised Comparison between Active and Passive

Patrick Blažek1, Jerko Ferri-Certić2, Hrvoje Vražić3

  • 1Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung für Elektrophysiologie, Fakultät für Medizin der Technischen Universität München, Munich, Germany. blazek@dhm.mhn.de.

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PubMed
Summary
This summary is machine-generated.

Pacemaker lead fixation can cause minor heart muscle damage, indicated by cardiac Troponin T (cTnT) release. This study found no significant difference in cTnT levels between active (screw) and passive (tine) fixation methods.

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Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Biomarkers

Background:

  • Pacemaker lead implantation can cause minimal myocardial injury, evidenced by an increase in cardiac Troponin T (cTnT).
  • The mechanism of lead fixation (active vs. passive) may influence the extent of this myocardial release.

Purpose of the Study:

  • To evaluate whether the type of ventricular lead fixation mechanism impacts the magnitude of cardiac Troponin T release post-pacemaker implantation.

Main Methods:

  • A randomized trial involving 326 patients undergoing de-novo pacemaker implantation or lead revision.
  • Patients received either active (screw) or passive (tine) fixation ventricular leads.
  • High-sensitive Troponin T (hsTnT) levels were measured before the procedure and the following day.

Main Results:

  • Both active and passive fixation methods resulted in an increase in hsTnT levels.
  • Median hsTnT increase was 0.009 ng/ml for screw-in leads and 0.008 ng/ml for tined leads.
  • The difference in hsTnT release between the two fixation types was not statistically significant (n.s.).

Conclusions:

  • Pacemaker implantation is associated with a release of hsTnT, indicating minor myocardial injury.
  • The choice between active (screw) and passive (tine) fixation for ventricular leads does not significantly alter the extent of myocardial injury or hsTnT release.