New Method of Cardiac Lead Evaluation Using Chest Radiography

Background and Objectives: There is currently no method that can be used for a precise evaluation of pacemaker leads using X-ray images, which could be a valuable add-on in the follow-up of patients. The aim of this paper was to create a simple method to measure selected points and lines using the chest radiography of patients with cardiac pacemakers. Materials and Methods: The study included 99 patients after permanent pacemaker implantation (72.0 ± 12.9 y; 58 W). The newly created method was used to evaluate the course of the leads based on an X-ray of the chest in an AP (posterior-anterior) projection (standing up) with optimization. The chest X-ray was applied to the original measurement grid, which was determined by specific anatomical points. For the purpose of this paper, a number of measurable parameters have been proposed. Results: The technical quality of the images was very good (4.50 ± 0.72). There were no gender-specific differences: women 4.46 ± 0.75/men 4.56 ± 0.67; p = 0.5183. The quality of the imaging of the leads was also good (3.72 ± 0.83), and no statistical differences were found between the genders. After verifying the technical quality of the X-ray images, the tract of the leads was measured. The only significant difference was found in parameter E-this value describing the so-called "death bend", which was significantly lower in women (3.98 ± 1.35) vs. men (4.58 ± 1.49): p = 0.039. Conclusions: The presented method permitted the leads of a cardiac pacemaker to be precisely described with good clinical validity using chest radiography.