Cardiac Perforation and Lead Dislodgement after Implantation of a MR-Conditional Pacing Lead: A Single-Center Experience

Authors

  • DARRYL A. ELMOUCHI M.D.,

    Corresponding author
    1. Frederik Meijer Heart and Vascular Institute, Spectrum Health, Grand Rapids, Michigan
    2. Department of Internal Medicine, Michigan State University College of Human Medicine, Grand Rapids, Michigan
    • Address for reprints: Darryl Elmouchi, M.D., F.H.R.S., Frederik Meijer Heart and Vascular Institute, Spectrum Health, Michigan State University College of Human Medicine, 2900 Bradford Street, NE, Grand Rapids, MI 49525. Fax: 616 710-4214; e-mail: darryl.elmouchi@spectrumhealth.org

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  • SHELLY ROSEMA R.N.,

    1. Frederik Meijer Heart and Vascular Institute, Spectrum Health, Grand Rapids, Michigan
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  • STACIE M. VANOOSTERHOUT M.Ed.,

    1. Frederik Meijer Heart and Vascular Institute, Spectrum Health, Grand Rapids, Michigan
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  • MOHSIN KHAN M.D.,

    1. Grand Rapids Medical Education Partners, Grand Rapids, Michigan
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  • ALAN T. DAVIS Ph.D.,

    1. Department of Internal Medicine, Michigan State University College of Human Medicine, Grand Rapids, Michigan
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  • ANDRE J. GAURI M.D.,

    1. Frederik Meijer Heart and Vascular Institute, Spectrum Health, Grand Rapids, Michigan
    2. Department of Internal Medicine, Michigan State University College of Human Medicine, Grand Rapids, Michigan
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  • BOHUSLAV FINTA M.D.,

    1. Frederik Meijer Heart and Vascular Institute, Spectrum Health, Grand Rapids, Michigan
    2. Department of Internal Medicine, Michigan State University College of Human Medicine, Grand Rapids, Michigan
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  • ALAN K. WOELFEL M.D.,

    1. Frederik Meijer Heart and Vascular Institute, Spectrum Health, Grand Rapids, Michigan
    2. Department of Internal Medicine, Michigan State University College of Human Medicine, Grand Rapids, Michigan
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  • NAGIB T. CHALFOUN M.D.

    1. Frederik Meijer Heart and Vascular Institute, Spectrum Health, Grand Rapids, Michigan
    2. Department of Internal Medicine, Michigan State University College of Human Medicine, Grand Rapids, Michigan
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  • Financial disclosures: DE, AG, BF, NC, report modest support from either or all: Medtronic, Biotronik, St. Jude Medical. The remaining authors have no financial disclosures.

  • Funding source: No funding sources to report.

Abstract

Objective

The purpose of our study was to determine if the rate of lead-related complications was increased with the Medtronic CapSureFix MRI™ SureScan™ 5086 MRI pacing lead (5086; Medtronic Inc., Minneapolis, MN, USA) compared to the previous generation of Medtronic CapSureFix Novus™ 5076 pacing lead (5076).

Background

The 5086 lead is a newly introduced active-fixation pacemaker lead designed to be used conditionally in a magnetic resonance (MR) scanner. This lead has specific design changes compared to the previous generation of 5076 pacing leads.

Methods

This study was a retrospective case control study of 65 consecutive patients implanted with two 5086 leads compared to 92 consecutive control patients implanted with two 5076 leads over a 14-month period at a high-volume tertiary care hospital.

Results

Pericarditis, pericardial effusion, cardiac tamponade, or death within 30 days of implant were seen in eight patients from the 5086 cohort and two from the 5076 cohort (odds ratio 6.3, 95% confidence interval 1.3–30.8, P = 0.02). Lead dislodgement occurred in four of the 5086 patients and in none of the 5076 patients (P < 0.03).

Conclusions

In a high-volume center, the incidence of pericarditis, cardiac perforation, tamponade, death, and lead dislodgement was significantly higher with the MR-conditional Medtronic 5086 lead when compared to the previous generation Medtronic 5076 lead.

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