J Korean Med Sci.  2016 Sep;31(9):1397-1402. 10.3346/jkms.2016.31.9.1397.

Complications of Cardiac Perforation and Lead Dislodgement with an MRI-Conditional Pacing Lead: a Korean Multi-Center Experience

• Kwon CH
• Choi JH
• Kim J
• Jo U
• Lee JH
• Lee WS
• Kim YR
• Lee SY
• Whang KW
• Yang J
• Kim SH
• Oh YS
• Park KM
• Nam GB
• Choi KJ
• Kim YH

• KMID: 2468271
• DOI: http://doi.org/10.3346/jkms.2016.31.9.1397

Abstract

Medtronic CapSureFix MRI 5086 pacing lead (5086; Medtronic, Inc., Minneapolis, MN, USA) has been reported to be associated with increased cardiac perforation and lead dislodgement. This study aimed to compare the incidence of cardiac perforation and lead dislodgement within 30 days after pacemaker implantation between 5086 MRI lead and previous Medtronic CapSureFix Novus 5076 non-MRI pacing lead. This was a nationwide, multicenter retrospective study in which we compared the incidence of adverse events between 277 patients implanted with 5086 lead and 205 patients implanted with 5076 lead between March 2009 and September 2014. Cardiac perforation within 30 days of pacemaker implantation occurred in 4 patients (1.4%) with the 5086 lead and in no patient with the 5076 lead (P = 0.084). Lead dislodgement occurred in 8 patients (2.9%) with the 5086 lead and in 5 patients (2.4%) with the 5076 lead (P = 0.764). On multivariate logistic regression analysis, age was significantly associated with cardiac perforation. Congestive heart failure and implantation of right atrial (RA) lead at RA free wall or septum were significant factors for the incidence of lead dislodgement and lead revision. The incidence of cardiac perforation and lead dislodgement were not statistically different between the patients with 5086 lead and the patients with 5076 lead. However, careful attention for cardiac perforation may be needed when using the 5086 MRI lead, especially in elderly patients.

Keyword

Complications; Magnetic Resonance Imaging; Pacemaker; Cardiac Perforation

MeSH Terms

Aged
Aged, 80 and over
Asian Continental Ancestry Group
Cardiac Pacing, Artificial/*adverse effects
Electrodes, Implanted
Equipment Failure/*statistics & numerical data
Female
Heart Failure/epidemiology/*etiology
Humans
Incidence
Logistic Models
*Magnetic Resonance Imaging
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Republic of Korea
Retrospective Studies

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