A Novel Clinical Perspective on New Masses after Lead Extraction (Ghosts) by Means of Intracardiac Echocardiography.
J Clin Med
; 9(8)2020 Aug 08.
Article
en En
| MEDLINE
| ID: mdl-32784437
ABSTRACT
BACKGROUND:
A lead-reactive fibrous capsule (FC) identified by ultrasounds as an atrial or ventricular lead thickness of more than 1 mm above the vendor-declared lead diameter (TL) and its local fibrotic attachment to the cardiac wall (FAC) have never been investigated in vivo, so their relationship with post-extraction masses (ghost) is not known.METHODS:
Intracardiac echocardiography (ICE) was performed twice during the same extraction procedure in 40 consecutive patients before and immediately after infected lead extractionResults:
The ghost detection rate was high 60% (24/40 patients); ICE could identify both TL and FAC, TL being noted in 25/40 (62%) patients and FAC in 12/40 patients (30%). Both TL and FAC were significantly associated with ghosts (p < 0.001 and p = 0.002, respectively), but TL had a higher prediction power. The specificity was similar 94% (15/16) and 100% (16/16), respectively, but TL showed a much higher sensitivity 100%, (24/24) vs 50% (12/24) (p = 0.016). The ghost group did not show a higher event rate in the follow-up (mean follow-up time = 20 ± 17 months).CONCLUSION:
ICE is able to evaluate both TL and FAC in vivo; ghosts are mostly benign remnants of fibrotic lead capsule cut off during extraction and retained inside the heart by FAC.
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Base de datos:
MEDLINE
Idioma:
En
Revista:
J Clin Med
Año:
2020
Tipo del documento:
Article
País de afiliación:
Italia