1
|
Agarwalla SV, Ellepola K, Sorokin V, Ihsan M, Silikas N, Neto AHC, Seneviratne CJ, Rosa V. Antimicrobial-free graphene nanocoating decreases fungal yeast-to-hyphal switching and maturation of cross-kingdom biofilms containing clinical and antibiotic-resistant bacteria. BIOMATERIALS AND BIOSYSTEMS 2022; 8:100069. [PMID: 36824379 PMCID: PMC9934433 DOI: 10.1016/j.bbiosy.2022.100069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 10/23/2022] [Accepted: 10/23/2022] [Indexed: 12/05/2022] Open
Abstract
Candida albicans and methicillin-resistant Staphylococcus aureus (MRSA) synergize in cross-kingdom biofilms to increase the risk of mortality and morbidity due to high resistance to immune and antimicrobial defenses. Biomedical devices and implants made with titanium are vulnerable to infections that may demand their surgical removal from the infected sites. Graphene nanocoating (GN) has promising anti-adhesive properties against C. albicans. Thus, we hypothesized that GN could prevent fungal yeast-to-hyphal switching and the development of cross-kingdom biofilms. Herein, titanium (Control) was coated with high-quality GN (coverage > 99%). Thereafter, mixed-species biofilms (C. albicans combined with S. aureus or MRSA) were allowed to develop on GN and Control. There were significant reductions in the number of viable cells, metabolic activity, and biofilm biomass on GN compared with the Control (CFU counting, XTT reduction, and crystal violet assays). Also, biofilms on GN were sparse and fragmented, whereas the Control presented several bacterial cells co-aggregating with intertwined hyphal elements (confocal and scanning electronic microscopy). Finally, GN did not induce hemolysis, an essential characteristic for blood-contacting biomaterials and devices. Thus, GN significantly inhibited the formation and maturation of deadly cross-kingdom biofilms, which can be advantageous to avoid infection and surgical removal of infected devices.
Collapse
Affiliation(s)
| | - Kassapa Ellepola
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, USA
| | - Vitaly Sorokin
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital, National University Health System, Singapore
| | - Mario Ihsan
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nikolaos Silikas
- Dentistry, The University of Manchester, Manchester, United Kingdom
| | - AH Castro Neto
- Centre for Advanced 2D Materials, National University of Singapore, Singapore
| | - Chaminda Jayampath Seneviratne
- School of Dentistry, The University of Queensland, Australia,Co-corresponding author at: School of Dentistry, The University of Queensland, 288 Herston Road, Cnr Bramston Terrace & Herston Road Herston QLD 4006, Australia.
| | - Vinicius Rosa
- Faculty of Dentistry, National University of Singapore, Singapore,Centre for Advanced 2D Materials, National University of Singapore, Singapore,ORCHIDS: Oral Care Health Innovations and Designs Singapore, National University of Singapore, Singapore,Corresponding author at: Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, 119085, Singapore.
| |
Collapse
|
2
|
Lee WC, Chen YL. Double Twist. Int Heart J 2021; 62:1156-1159. [PMID: 34544971 DOI: 10.1536/ihj.21-019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A rare complication about "Twiddler syndrome" is reported, and an interesting image about "double twist" is presented. A 78-year-old woman received a single-chamber implantable cardioverter defibrillator (ICD) for secondary prevention of ventricular arrhythmia. After she played mahjong (a traditional Chinese board game) overnight, her ICD lead sense amplitude decreased suddenly and did not recover. The intracardiac electrogram of ICD also found ventricular lead noise before this episode. Chest radiography revealed a twisted lead at the ICD pocket and a twisted and retracted ICD lead in the right atrium. An old ICD lead could not be straightened and removed, and a new ICD lead was implanted at the right ventricle. Anti-coagulation was used to prevent thrombosis for the old ICD lead.
Collapse
Affiliation(s)
- Wei-Chieh Lee
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University.,Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| | - Yung-Lung Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine
| |
Collapse
|
3
|
Kim E, Davogustto G, Huang S, Crossley GH, Montgomery JA. Clinical and radiographic predictors of cardiovascular implantable electronic device lead failure at the time of initial implantation. J Arrhythm 2021; 37:1086-1092. [PMID: 34386136 PMCID: PMC8339104 DOI: 10.1002/joa3.12559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/12/2021] [Accepted: 05/03/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To assess the clinical and radiographic factors associated with lead failure by comparing subjects with lead failure within 10 years of implantation with an implant-year-matched group without lead failure. METHODS A case-control study with 49 subjects who received Cardiac Implantable Electronic Device (CIED) between January 1, 1999 and July 31, 2008 and developed lead failure within 10 years of implantation in a single center. The control group consisted of subjects (n = 54) with normally functioning leads matched one-to-one by implant year. RESULTS Among the failure group, the meantime from implantation to device lead failure was 4.70 ± 2.94 years. Older age at implantation was associated with a lower likelihood of lead failure (Odds Ratio (OR) = 0.28 (75 vs 42 years old), 95% CI 0.12-0.63, P = .002). A larger smallest loop diameter on the chest radiograph was also associated with a lower likelihood of lead failure (OR = 0.51 (31 vs 14 mm), 95% CI 0.27-0.97, P = .04). CIED type (defibrillator vs pacemaker) and Ottawa scores were not significantly associated with lead failure. Among lead-specific parameters, defibrillation lead vs pace-sense lead was associated with lead failure (OR = 3.91, 95% CI 1.95-7.81, P < .001). CONCLUSIONS Younger age, defibrillation leads, and small lead loops are associated with lead failure in CIEDs. Techniques to avoid tight loops in the pocket could potentially reduce the risk of lead failure and bear important implications for the implanting physician.
Collapse
Affiliation(s)
- Eun‐jeong Kim
- Department of MedicineDivision of Cardiovascular MedicineUniversity of California San FranciscoSan FranciscoCAUSA
| | - Giovanni Davogustto
- Department of MedicineDivision of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Shi Huang
- Vanderbilt University Medical CenterDepartment of BiostatisticsVanderbilt University Medical CenterNashvilleTNUSA
| | - George H. Crossley
- Department of MedicineDivision of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Jay A. Montgomery
- Department of MedicineDivision of Cardiovascular MedicineVanderbilt University Medical CenterNashvilleTNUSA
| |
Collapse
|
4
|
Beaser AD, Aziz Z, Besser SA, Jones CI, Jameria Z, Kannan A, Upadhyay GA, Broman MT, Ozcan C, Tung R, Nayak HM. Characterization of Lead Adherence Using Intravascular Ultrasound to Assess Difficulty of Transvenous Lead Extraction. Circ Arrhythm Electrophysiol 2020; 13:e007726. [DOI: 10.1161/circep.119.007726] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Clinical factors associated with development of intravascular lead adherence (ILA) are unreliable predictors. Because vascular injury in the superior vena cava-right atrium during transvenous lead extraction is more likely to occur in segments with higher degrees of ILA, reliable and accurate assessment of ILA is warranted. We hypothesized that intravascular ultrasound (IVUS) could accurately visualize and quantify ILA and degree of ILA correlates with transvenous lead extraction difficulty.
Methods:
Serial imaging of leads occurred before transvenous lead extraction using IVUS. ILA areas were classified as high or low grade. Degree of extraction difficulty was assessed using 2 metrics and correlated with ILA grade. Lead extraction difficulty was calculated for each patient and compared with IVUS findings.
Results:
One hundred fifty-eight vascular segments in 60 patients were analyzed: 141 (89%) low grade versus 17 (11%) high grade. Median extraction time (low=0 versus high grade=97 seconds,
P
<0.001) and median laser pulsations delivered (low=0 versus high grade=5852,
P
<0.001) were significantly higher in high-grade segments. Most patients with low lead extraction difficulty score had low ILA grades. Eighty-six percentage of patients with high lead extraction difficulty score had low IVUS grade, and the degree of transvenous lead extraction difficulty was similar to patients with low IVUS grades and lead extraction difficulty scores.
Conclusions:
IVUS is a feasible imaging modality that may be useful in characterizing ILA in the superior vena cava-right atrium region. An ILA grading system using imaging correlates with extraction difficulty. Most patients with clinical factors associated with higher extraction difficulty may exhibit lower ILA and extraction difficulty based on IVUS imaging.
Graphic Abstract:
A
graphic abstract
is available for this article.
Collapse
Affiliation(s)
- Andrew D. Beaser
- Department of Medicine, Section of Cardiology, University of Chicago Pritzker School of Medicine, IL
| | - Zaid Aziz
- Department of Medicine, Section of Cardiology, University of Chicago Pritzker School of Medicine, IL
| | - Stephanie A. Besser
- Department of Medicine, Section of Cardiology, University of Chicago Pritzker School of Medicine, IL
| | - Christopher I. Jones
- Department of Medicine, Section of Cardiology, University of Chicago Pritzker School of Medicine, IL
| | - Zenith Jameria
- Department of Medicine, Section of Cardiology, University of Chicago Pritzker School of Medicine, IL
| | - Arun Kannan
- Department of Medicine, Section of Cardiology, University of Chicago Pritzker School of Medicine, IL
| | - Gaurav A. Upadhyay
- Department of Medicine, Section of Cardiology, University of Chicago Pritzker School of Medicine, IL
| | - Michael T. Broman
- Department of Medicine, Section of Cardiology, University of Chicago Pritzker School of Medicine, IL
| | - Cevher Ozcan
- Department of Medicine, Section of Cardiology, University of Chicago Pritzker School of Medicine, IL
| | - Roderick Tung
- Department of Medicine, Section of Cardiology, University of Chicago Pritzker School of Medicine, IL
| | - Hemal M. Nayak
- Department of Medicine, Section of Cardiology, University of Chicago Pritzker School of Medicine, IL
| |
Collapse
|
5
|
Jone PN. Applications of three-dimensional transesophageal echocardiography in congenital heart disease. Echocardiography 2020; 37:1665-1672. [PMID: 32594626 DOI: 10.1111/echo.14780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 12/19/2022] Open
Abstract
Three-dimensional echocardiography allows for presurgical planning for congenital heart disease, reduces radiation using fusion imaging in catheter interventions, and provides guidance during catheter interventions and lead placements or extractions. The purpose of this review is to detail applications of three-dimensional transesophageal echocardiography in presurgical planning of congenital heart disease, guidance of catheter interventions such as fusion imaging, and guidance in electrophysiology lead extractions or placements.
Collapse
Affiliation(s)
- Pei-Ni Jone
- Pediatric Cardiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
| |
Collapse
|
6
|
Gould J, Sidhu BS, Porter B, Sieniewicz BJ, Freeman S, de Wilt EC, Glover JC, Razavi R, Rinaldi CA. Financial and resource costs of transvenous lead extraction in a high-volume lead extraction centre. Heart 2020; 106:931-937. [PMID: 31932286 PMCID: PMC7282498 DOI: 10.1136/heartjnl-2019-315839] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 12/13/2019] [Accepted: 12/13/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES Transvenous lead extraction (TLE) poses a significant economic and resource burden on healthcare systems; however, limited data exist on its true cost. We therefore estimate real-world healthcare reimbursement costs of TLE to the UK healthcare system at a single extraction centre. METHODS Consecutive admissions entailing TLE at a high-volume UK centre between April 2013 and March 2018 were prospectively recorded in a computer registry. In the hospital's National Health Service (NHS) clinical coding/reimbursement database, 447 cases were identified. Mean reimbursement cost (n=445) and length of stay (n=447) were calculated. Ordinary least squares regressions estimated the relationship between cost (bed days) and clinical factors. RESULTS Mean reimbursement cost per admission was £17 399.09±£13 966.49. Total reimbursement for all TLE admissions was £7 777 393.51. Mean length of stay was 16.3±15.16 days with a total of 7199 bed days. Implantable cardioverter-defibrillator and cardiac resynchronisation therapy defibrillator devices incurred higher reimbursement costs (70.5% and 68.7% higher, respectively, both p<0.001). Heart failure and prior valve surgery also incurred significantly higher reimbursement costs. Prior valve surgery and heart failure were associated with 8.3 (p=0.017) and 5.5 (p=0.021) additional days in hospital, respectively. CONCLUSIONS Financial costs to the NHS from TLE are substantial. Consideration should therefore be given to cost/resource-sparing potential of leadless/extravascular cardiac devices that negate the need for TLE particularly in patients with prior valve surgery and/or heart failure. Additionally, use of antibiotic envelopes and other interventions that reduce infection risk in patients receiving transvenous leads should be considered.
Collapse
Affiliation(s)
- Justin Gould
- Cardiology Department, Guy's and Saint Thomas' NHS Foundation Trust, London, UK .,King's College London, London, UK
| | - Baldeep S Sidhu
- Cardiology Department, Guy's and Saint Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | - Bradley Porter
- Cardiology Department, Guy's and Saint Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | - Benjamin J Sieniewicz
- Cardiology Department, Guy's and Saint Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | | | | | | | - Reza Razavi
- Cardiology Department, Guy's and Saint Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | - Christopher A Rinaldi
- Cardiology Department, Guy's and Saint Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| |
Collapse
|
7
|
Mehdi B, Kaveh H, Ali VF. Implantable Cardioverter-Defibrillators in Patients with ESRD: Complications, Management, and Literature Review. Curr Cardiol Rev 2019; 15:161-166. [PMID: 30657044 PMCID: PMC6719391 DOI: 10.2174/1573403x15666190118123754] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 11/26/2018] [Accepted: 01/10/2019] [Indexed: 01/25/2023] Open
Abstract
Background: Cardiovascular diseases are the leading cause of death among dialysis pa-tients, accounting for about 40% of all their mortalities. Sudden cardiac death (SCD) is culpable for 37.5% of all deaths among patients with end-stage renal disease (ESRD). Implantable cardioverter-defibrillators (ICDs) should be considered in dialysis patients for the primary or secondary preven-tion of SCD. Recent studies on the implementation of ICD/cardiac resynchronization therapy do not exclude patients with ESRD; however, individualized decisions should be made in this group of pa-tients. A thorough evaluation of the benefits of ICD implementation in patients with ESRD requires several large-scale mortality studies to compare and follow up patients with ESRD with and without ICDs. In the present study, we sought to determine and clarify the complications associated with ICD implementation and management thereof in patients suffering from ESRD. Methods: To assess the complications allied to the implementation of ICDs and their management in patients with ESRD, we reviewed available related articles in the literature. Results and Conclusions: ICD implementation in dialysis patients has several complications, which has limited its usage. Based on our literature review, the complications of ICD implementation can be categorized as follows: (1) Related to implantation procedures, hematoma, and pneumothorax; (2) Re-lated to the device/lead such as lead fracture and lead dislodgment; (3) Infection; and (4) Central vein thrombosis. Hence, the management of the complications of ICDs in this specific group of patients is of vital importance.
Collapse
Affiliation(s)
- Bayati Mehdi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hosseini Kaveh
- Cardiology Resident, MS in Public Health, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Vasheghani-Farahani Ali
- Cardiac Primary Prevention, Research Center (CPPRC), Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Electrophysiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
8
|
Gould J, Klis M, Porter B, Sieniewicz BJ, Sidhu BS, Claridge S, Williams SE, Shetty A, O’Neill M, Gill J, Rinaldi CA. Transvenous lead extraction in patients with cardiac resynchronization therapy devices is not associated with increased 30-day mortality. Europace 2018; 21:928-936. [DOI: 10.1093/europace/euy290] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 11/14/2018] [Indexed: 12/30/2022] Open
Affiliation(s)
- Justin Gould
- Department of Cardiology, Lower Ground Floor, South Wing, Guy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, UK
| | - Magdalena Klis
- Department of Cardiology, Lower Ground Floor, South Wing, Guy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, UK
| | - Bradley Porter
- Department of Cardiology, Lower Ground Floor, South Wing, Guy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, UK
| | - Benjamin J Sieniewicz
- Department of Cardiology, Lower Ground Floor, South Wing, Guy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, UK
| | - Baldeep S Sidhu
- Department of Cardiology, Lower Ground Floor, South Wing, Guy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, UK
| | - Simon Claridge
- Department of Cardiology, Lower Ground Floor, South Wing, Guy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, UK
| | - Steven E Williams
- Department of Cardiology, Lower Ground Floor, South Wing, Guy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, UK
| | - Anoop Shetty
- Department of Cardiology, Lower Ground Floor, South Wing, Guy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, UK
| | - Mark O’Neill
- Department of Cardiology, Lower Ground Floor, South Wing, Guy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, UK
| | - Jaswinder Gill
- Department of Cardiology, Lower Ground Floor, South Wing, Guy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, UK
| | - Christopher A Rinaldi
- Department of Cardiology, Lower Ground Floor, South Wing, Guy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, UK
| |
Collapse
|
9
|
Claridge S, Johnson J, Sadnan G, Behar JM, Porter B, Sieniewicz B, Jackson T, Webb J, Gould J, Sohal M, Hamid S, Patel N, Gill J, Rinaldi CA. Predictors and outcomes of patients requiring repeat transvenous lead extraction of pacemaker and defibrillator leads. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2018; 41:155-160. [DOI: 10.1111/pace.13266] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 10/23/2017] [Accepted: 12/03/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Simon Claridge
- Department of Cardiology; Guy's and St Thomas’ Hospital Trust; London SE1 7EH UK
- Division of Imaging Sciences and Biomedical Engineering; King's College London; London SE1 7EH UK
| | - Jonathan Johnson
- Department of Cardiology; Guy's and St Thomas’ Hospital Trust; London SE1 7EH UK
- Division of Imaging Sciences and Biomedical Engineering; King's College London; London SE1 7EH UK
| | - Gazi Sadnan
- Department of Cardiology; Guy's and St Thomas’ Hospital Trust; London SE1 7EH UK
- Division of Imaging Sciences and Biomedical Engineering; King's College London; London SE1 7EH UK
| | - Jonathan M. Behar
- Department of Cardiology; Guy's and St Thomas’ Hospital Trust; London SE1 7EH UK
- Division of Imaging Sciences and Biomedical Engineering; King's College London; London SE1 7EH UK
| | - Bradley Porter
- Department of Cardiology; Guy's and St Thomas’ Hospital Trust; London SE1 7EH UK
- Division of Imaging Sciences and Biomedical Engineering; King's College London; London SE1 7EH UK
| | - Benjamin Sieniewicz
- Department of Cardiology; Guy's and St Thomas’ Hospital Trust; London SE1 7EH UK
- Division of Imaging Sciences and Biomedical Engineering; King's College London; London SE1 7EH UK
| | - Tom Jackson
- Department of Cardiology; Guy's and St Thomas’ Hospital Trust; London SE1 7EH UK
- Division of Imaging Sciences and Biomedical Engineering; King's College London; London SE1 7EH UK
| | - Jessica Webb
- Department of Cardiology; Guy's and St Thomas’ Hospital Trust; London SE1 7EH UK
- Division of Imaging Sciences and Biomedical Engineering; King's College London; London SE1 7EH UK
| | - Justin Gould
- Department of Cardiology; Guy's and St Thomas’ Hospital Trust; London SE1 7EH UK
- Division of Imaging Sciences and Biomedical Engineering; King's College London; London SE1 7EH UK
| | - Manav Sohal
- Department of Cardiology; Guy's and St Thomas’ Hospital Trust; London SE1 7EH UK
- Division of Imaging Sciences and Biomedical Engineering; King's College London; London SE1 7EH UK
| | - Shoaib Hamid
- Department of Cardiology; Guy's and St Thomas’ Hospital Trust; London SE1 7EH UK
- Division of Imaging Sciences and Biomedical Engineering; King's College London; London SE1 7EH UK
| | - Nik Patel
- Department of Cardiology; Guy's and St Thomas’ Hospital Trust; London SE1 7EH UK
- Division of Imaging Sciences and Biomedical Engineering; King's College London; London SE1 7EH UK
| | - Jaswinder Gill
- Department of Cardiology; Guy's and St Thomas’ Hospital Trust; London SE1 7EH UK
- Division of Imaging Sciences and Biomedical Engineering; King's College London; London SE1 7EH UK
| | - Christopher A. Rinaldi
- Department of Cardiology; Guy's and St Thomas’ Hospital Trust; London SE1 7EH UK
- Division of Imaging Sciences and Biomedical Engineering; King's College London; London SE1 7EH UK
| |
Collapse
|
10
|
Hao Y, Li Y, Liao D, Yang L, Liu F. A comparative analysis of the effectiveness of active versus passive atrial lead fixation in Chinese patients with cardiac implantable electrical devices: a long term, retrospective, observational, single-center study. Curr Med Res Opin 2017; 33:573-578. [PMID: 28008765 DOI: 10.1080/03007995.2016.1275938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Data comparing active atrial lead fixation with passive atrial lead fixation in Chinese patients with cardiovascular implantable electronic devices (CIEDs) for atrial pacing is limited. Our study evaluated the effectiveness of active fixation versus passive fixation of atrial leads by observing the lead performance parameters. METHODS This retrospective, long-term, single-center study included a cohort of Chinese patients who underwent CIED implantation at the Department of Cardiology of People's Hospital of Yuxi City, China, from 1 March 2010 to 1 March 2015. Efficacy was determined by comparing implantation time, threshold values, incidence of lead dislocation/failure, and lead-related complications between the two groups. RESULTS Of the 1217 patients, active and passive atrial lead fixation were performed in 530 (mean age, 69.37 ± 11.44 years) and 497 (mean age, 68.33 ± 10.96 years). The active fixation group reported significantly lower mean atrial implantation times (P = .0001) and threshold values (P = .044) compared with the passive atrial lead fixation group. In addition, threshold values in the active atrial lead fixation group were stable throughout the observation period. No instances of myocardial perforation, cardiac tamponade, implantation failure, or electrode dislocation/re-fixation were reported in the active atrial lead fixation group. A favorable decrease in patient comfort parameters such as bed rest time (P = .027) and duration of hospital stay (P = .038) were also observed in the active lead fixation group. CONCLUSION Active atrial lead fixation demonstrated greater stability, steady long-term thresholds and minimal lead-related complications compared to passive lead fixation in Chinese patients with CIEDs.
Collapse
Affiliation(s)
- Yinglu Hao
- a Department of Cardiology , People's Hospital of Yuxi City , Yuxi , China
| | - Yanping Li
- a Department of Cardiology , People's Hospital of Yuxi City , Yuxi , China
| | - Derong Liao
- a Department of Cardiology , People's Hospital of Yuxi City , Yuxi , China
| | - Ling Yang
- a Department of Cardiology , People's Hospital of Yuxi City , Yuxi , China
| | - Fangyan Liu
- a Department of Cardiology , People's Hospital of Yuxi City , Yuxi , China
| |
Collapse
|
11
|
Bernstein WK. Calm Before the Storm: An Uncomplicated Epicardial Lead Extraction Resulting in DIC and Patient Demise. ACTA ACUST UNITED AC 2016; 7:96-7. [PMID: 27525495 DOI: 10.1213/xaa.0000000000000355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A previously stable 77-year-old man with significant cardiac history underwent an uneventful extraction of a Citrobacter-infected and eroded pacemaker lead. His postoperative course was acutely complicated by respiratory failure and quickly progressed into disseminated intravascular coagulation, acute renal failure, shock liver, and ventricular tachycardic arrest. I believe that this is the first case report of such a drastic turn of events after a routine pacemaker lead extraction.
Collapse
Affiliation(s)
- Wendy K Bernstein
- From the Division of Cardiothoracic Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland
| |
Collapse
|
12
|
Extraction of a 17-year-old pacing lead chronically dislocated into the liver vein. J Vasc Access 2011; 13:130-1. [PMID: 21725952 DOI: 10.5301/jva.2011.8441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2011] [Indexed: 11/20/2022] Open
|