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See Latest ArticlesAutopsy and clinical context in deceased patients with implanted pacemakers and defibrillators: intracardiac findings near their leads and electrodes
Europace, 08/19/09
Novak M et al. – Findings show: 1) thrombi on ventricular/atrial leads in 33%/48% of pts, 2) bipolar lead rings fixed by fibrous tissue in 68%/22%, 3) connective tissue bridges or tunnels in ventricle/atrium in 87%/71%, and 4) ventricular leads fixed to valve or penetrating chordae in 46% of pts. Caution when extracting leads is recommended.
Methods- Study of intracardiac findings near leads and causes of death in pacemaker/defibrillator pts
- Special autopsy on 78 hospital pts
- Age at death: 77.9 ± 10.0 yrs, implantation-death interval 4.0 ± 3.3 yrs, ventricular leads 78, atrial leads 21
- Thrombi along leads in brachiocephalic vein/upper caval vein (BV/UCV) in 22 (7), in right atrium (RA) in 11 (8), and in right ventricle (RV) in 11 cases
- Bipolar lead rings fixed by fibrous tissue in 43 (4) cases
- Connective tissue bridges and tunnels in BV/UCV in 44 (13), in RA in 17 (15), and in RV in 68 cases, length of 0.2–12.0 cm
- Right ventricular leads in tricuspidal orifice fixed by fibrous tissue in 11 and penetrating chordae in 25 cases
- Main causes of death: heart failure in 35, pulmonary embolism in 9, myocardial infarction in 11 cases
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