Pacemaker Implantation Associated Myocardial Micro-Damage: A Randomised Comparison between Active and Passive Fixation Leads.
Patrick BlazekJerko Ferri-CertićHrvoje VražićCarsten LennerzChristian GrebmerKazuaki KaitaniMartin KarchBoris StarčevićVerena SemmlerChristof KolbPublished in: Scientific reports (2018)
Fixation of the pacemaker leads during pacemaker implantation leads to an increase of cardiac Troponin T (cTnT) that can be interpreted as a sign of minimal myocardial damage. This trial evaluates whether the mechanism type of lead fixation influences the magnitude of cTnT release. Patients having a de-novo cardiac pacemaker implantation or a lead revision were centrally randomized to receive either a ventricular lead with an active (screw) or passive (tine) fixation mechanism. High-sensitive Troponin T (hsTnT) was determined on the day of the procedure beforehand and on the following day. 326 Patients (median age (IQR) 75.0 (69.0-80.0) years, 64% male) from six international centers were randomized to receive ventricular leads with an active (n = 166) or passive (n = 160) fixation mechanism. Median (IQR) hsTnT levels increased by 0.009 (0.004-0.021) ng/ml in the group receiving screw-in ventricular leads and by 0.008 (0.003-0.030) ng/ml in the group receiving tined ventricular leads (n.s.). In conclusion pacemaker implantations are followed by a release of hsTnT. The choice between active or passive fixation ventricular leads does not have a significant influence on the extent of myocardial injury and the magnitude of hsTnT release.
Keyphrases
- left ventricular
- minimally invasive
- heart failure
- end stage renal disease
- double blind
- open label
- clinical trial
- newly diagnosed
- ejection fraction
- chronic kidney disease
- phase iii
- vena cava
- catheter ablation
- placebo controlled
- prognostic factors
- study protocol
- phase ii
- peritoneal dialysis
- oxidative stress
- randomized controlled trial
- total knee arthroplasty
- atrial fibrillation
- patient reported