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

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.