Incidence and predictors of cardiac perforation after permanent pacemaker placement

作者: Srijoy Mahapatra , Kevin A. Bybee , T. Jared Bunch , Raul E. Espinosa , Lawrence J. Sinak

DOI: 10.1016/J.HRTHM.2005.06.011

关键词:

摘要: Background Pericardial effusion, a sign of cardiac perforation, may complicate permanent pacemaker placement. Risk factors for development post-permanent effusion have not been evaluated. Objectives The purpose this study was to determine the predictors symptomatic pericardial after Methods Mayo Clinic and echocardiogram databases were cross-referenced. From 1995 2003, 4,280 pacemakers implanted. Fifty (1.2%) patients developed significant symptoms consistent with perforation. They randomly matched 100 without Results strongest postimplant by univariate analysis concomitant use temporary transvenous (hazard ratio [HR] 3.2, 95% confidence interval [CI] 1.6–6.2, P = .001) or steroid within 7 days prior implant (HR 4.1, CI 1.1–10, .003). Weaker helical screw ventricular leads, body mass index (BMI) 35 mmHg 0.70, 0.44–0.97, .01) BMI >30 0.62, 0.41–0.93, .01). Multivariate 2.7, 1.4–3.9, .01), leads 2.5; 1.4-3.8, .04), steroids 1.1–5.4, .04). Right systolic pressure >35 only protective factor 0.50–0.92, .02). Conclusion incidence effusions is low. In order minimize periprocedural effusions, placement should be avoided unless essential, particular care taken when placing in who are taking steroids.

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