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Inadvertent Lead Malposition in the Left Heart during Implantation of Cardiac Electric Devices: A Systematic Review

Background. The inadvertent lead malposition in the left heart (ILMLH) is an under-recognized event, which may complicate the implantation of cardiac electronic devices (CIEDs). Methods. We investigated the clinical conditions associated with ILMLH and the treatment strategies in these patients. We...

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Autores principales: Spighi, Lorenzo, Notaristefano, Francesco, Piraccini, Silvia, Giuffrè, Giuseppe, Barengo, Alberto, D’Ammando, Matteo, Notaristefano, Salvatore, Bagliani, Giuseppe, Zingarini, Gianluca, Angeli, Fabio, Verdecchia, Paolo, Cavallini, Claudio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604651/
https://www.ncbi.nlm.nih.gov/pubmed/36286313
http://dx.doi.org/10.3390/jcdd9100362
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author Spighi, Lorenzo
Notaristefano, Francesco
Piraccini, Silvia
Giuffrè, Giuseppe
Barengo, Alberto
D’Ammando, Matteo
Notaristefano, Salvatore
Bagliani, Giuseppe
Zingarini, Gianluca
Angeli, Fabio
Verdecchia, Paolo
Cavallini, Claudio
author_facet Spighi, Lorenzo
Notaristefano, Francesco
Piraccini, Silvia
Giuffrè, Giuseppe
Barengo, Alberto
D’Ammando, Matteo
Notaristefano, Salvatore
Bagliani, Giuseppe
Zingarini, Gianluca
Angeli, Fabio
Verdecchia, Paolo
Cavallini, Claudio
author_sort Spighi, Lorenzo
collection PubMed
description Background. The inadvertent lead malposition in the left heart (ILMLH) is an under-recognized event, which may complicate the implantation of cardiac electronic devices (CIEDs). Methods. We investigated the clinical conditions associated with ILMLH and the treatment strategies in these patients. We made a systematic review of the literature and identified 132 studies which reported 157 patients with ILMLH. Results. The mean age of patients was 68 years, and 83 were women. ILMLH was diagnosed, on average, 365 days after CIEDs implantation. Coexisting conditions were patent foramen ovale in 29% of patients, arterial puncture in 24%, perforation of the interatrial septum in 20%, atrial septal defect in 16% and perforation of the interventricular septum in 4%. At the time of diagnosis of ILMLH, 46% of patients were asymptomatic, 31% had acute TIA or stroke and 15% had overt heart failure. Overall, 14% of patients were receiving anticoagulants at the time of diagnosis of ILMLH. After diagnosis of ILMLH, percutaneous or surgical lead extraction was carried out in 93 patients (59%), whereas 43 (27%) received anticoagulation. During a mean 9-month follow-up after diagnosis of ILMLH, four patients experienced TIA or stroke (three on oral anticoagulant therapy and one after percutaneous lead extraction). Conclusion. ILMLH is a rare complication, which is usually diagnosed about one year after implantation of CIEDs. An early diagnosis of ILMLH is important. Lead extraction is a safe and effective alternative to anticoagulants.
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spelling pubmed-96046512022-10-27 Inadvertent Lead Malposition in the Left Heart during Implantation of Cardiac Electric Devices: A Systematic Review Spighi, Lorenzo Notaristefano, Francesco Piraccini, Silvia Giuffrè, Giuseppe Barengo, Alberto D’Ammando, Matteo Notaristefano, Salvatore Bagliani, Giuseppe Zingarini, Gianluca Angeli, Fabio Verdecchia, Paolo Cavallini, Claudio J Cardiovasc Dev Dis Systematic Review Background. The inadvertent lead malposition in the left heart (ILMLH) is an under-recognized event, which may complicate the implantation of cardiac electronic devices (CIEDs). Methods. We investigated the clinical conditions associated with ILMLH and the treatment strategies in these patients. We made a systematic review of the literature and identified 132 studies which reported 157 patients with ILMLH. Results. The mean age of patients was 68 years, and 83 were women. ILMLH was diagnosed, on average, 365 days after CIEDs implantation. Coexisting conditions were patent foramen ovale in 29% of patients, arterial puncture in 24%, perforation of the interatrial septum in 20%, atrial septal defect in 16% and perforation of the interventricular septum in 4%. At the time of diagnosis of ILMLH, 46% of patients were asymptomatic, 31% had acute TIA or stroke and 15% had overt heart failure. Overall, 14% of patients were receiving anticoagulants at the time of diagnosis of ILMLH. After diagnosis of ILMLH, percutaneous or surgical lead extraction was carried out in 93 patients (59%), whereas 43 (27%) received anticoagulation. During a mean 9-month follow-up after diagnosis of ILMLH, four patients experienced TIA or stroke (three on oral anticoagulant therapy and one after percutaneous lead extraction). Conclusion. ILMLH is a rare complication, which is usually diagnosed about one year after implantation of CIEDs. An early diagnosis of ILMLH is important. Lead extraction is a safe and effective alternative to anticoagulants. MDPI 2022-10-20 /pmc/articles/PMC9604651/ /pubmed/36286313 http://dx.doi.org/10.3390/jcdd9100362 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Spighi, Lorenzo
Notaristefano, Francesco
Piraccini, Silvia
Giuffrè, Giuseppe
Barengo, Alberto
D’Ammando, Matteo
Notaristefano, Salvatore
Bagliani, Giuseppe
Zingarini, Gianluca
Angeli, Fabio
Verdecchia, Paolo
Cavallini, Claudio
Inadvertent Lead Malposition in the Left Heart during Implantation of Cardiac Electric Devices: A Systematic Review
title Inadvertent Lead Malposition in the Left Heart during Implantation of Cardiac Electric Devices: A Systematic Review
title_full Inadvertent Lead Malposition in the Left Heart during Implantation of Cardiac Electric Devices: A Systematic Review
title_fullStr Inadvertent Lead Malposition in the Left Heart during Implantation of Cardiac Electric Devices: A Systematic Review
title_full_unstemmed Inadvertent Lead Malposition in the Left Heart during Implantation of Cardiac Electric Devices: A Systematic Review
title_short Inadvertent Lead Malposition in the Left Heart during Implantation of Cardiac Electric Devices: A Systematic Review
title_sort inadvertent lead malposition in the left heart during implantation of cardiac electric devices: a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9604651/
https://www.ncbi.nlm.nih.gov/pubmed/36286313
http://dx.doi.org/10.3390/jcdd9100362
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