Superior Vena Cava Echocardiography as a Screening Tool to Predict Cardiovascular Implantable Electronic Device Lead Fibrosis

다국어 초록 (Multilingual Abstract)

Background: Currently there is no noninvasive imaging modality used to risk stratify patients requiring lead extractions. Wereport the novel use of superior vena cava (SVC) echocardiography to identify lead fibrosis and complex cardiac implantableelectronic device (CIED) lead extraction. With an aging population and expanding indications for cardiac device implantation,the ability to deal with the complications associated with chronically implanted device has also increased.
Methods: This was a retrospective analysis of Doppler echocardiography recorded in our outpatient Electrophysiology/DeviceClinic office over 6 months. Images from 109 consecutive patients were reviewed.
Results: 62% (68/109) did not have a CIED and 38% (41/109) had a CIED. In patients without a CIED, 6% (4/68) displayedturbulent color flow by Doppler in the SVC, while 22% (9/41) of patients with a CIED displayed turbulent flow. Fisher’s exacttest found a statistically significant difference between the two groups (p value < 0.05). The CIED group was subdivided into 2groups based on device implant duration (< 2 years vs. ≥ 2 years). Of the CIED implanted for ≥ 2 years, 27% (9/33) hadturbulent flow in the SVC by Doppler, while no patients (0/8) with implant durations < 2 years demonstrated turbulent flow.
Nine patients underwent subsequent lead extraction. A turbulent color pattern successfully identified all 3 patients that hadsignificant fibrosis in the SVC found during extraction.
Conclusion: Our data suggests that assessing turbulent flow using color Doppler in the SVC may be a valuable noninvasivescreening tool prior to lead extraction in predicting complex procedures.

참고문헌 (Reference)

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