Usefulness of right ventriculography compared with computed tomography for ruling out the possibility of lead perforation before lead extraction.
<h4>Purpose</h4>High-risk patients can be identified by preprocedural computed tomography (CT) before lead extraction. However, CT evaluation may be difficult especially for lead tip identification due to artifacts in the leads. Selective right ventriculography (RVG) may enable preproced...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0245502 |
| _version_ | 1818400547563110400 |
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| author | Saori Asada Nobuhiro Nishii Takayoshi Shinya Akihito Miyoshi Yoshimasa Morimoto Masakazu Miyamoto Koji Nakagawa Kazufumi Nakamura Hiroshi Morita Hiroshi Ito |
| author_facet | Saori Asada Nobuhiro Nishii Takayoshi Shinya Akihito Miyoshi Yoshimasa Morimoto Masakazu Miyamoto Koji Nakagawa Kazufumi Nakamura Hiroshi Morita Hiroshi Ito |
| author_sort | Saori Asada |
| collection | DOAJ |
| description | <h4>Purpose</h4>High-risk patients can be identified by preprocedural computed tomography (CT) before lead extraction. However, CT evaluation may be difficult especially for lead tip identification due to artifacts in the leads. Selective right ventriculography (RVG) may enable preprocedural evaluation of lead perforation. We investigated the efficacy of RVG for identifying right ventricular (RV) lead perforation compared with CT in patients who underwent lead extraction.<h4>Methods</h4>Ninety-five consecutive patients who were examined by thin-section non-ECG-gated multidetector CT and RVG before lead extraction were investigated retrospectively. Newly recognized pericardial effusion after lead extraction was used as a reference standard for lead perforation. We analyzed the prevalence of RV lead perforation diagnosed by each method. The difference in the detection rates of lead perforation by RVG and CT was evaluated.<h4>Results</h4>Of the 115 RV leads in the 95 patients, lead perforation was diagnosed for 35 leads using CT, but the leads for 29 (83%) of those 35 leads diagnosed as lead perforation by CT were shown to be within the right ventricle by RVG. Three patients with 5 leads could not be evaluated by CT due to motion artifacts. The diagnostic accuracies of RVG and CT were significantly different (p < 0.001). There was no complication of pericardial effusion caused by RV lead extraction.<h4>Conclusion</h4>RVG for identification of RV lead perforation leads to fewer false-positives compared to non-ECG-gated CT. However, even in cases in which lead perforation is diagnosed, most leads may be safely extracted by transvenous lead extraction. |
| first_indexed | 2024-12-14T07:38:19Z |
| format | Article |
| id | doaj.art-b22d00285f17438e879190d66c051ca9 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-14T07:38:19Z |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-b22d00285f17438e879190d66c051ca92022-12-21T23:11:07ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01163e024550210.1371/journal.pone.0245502Usefulness of right ventriculography compared with computed tomography for ruling out the possibility of lead perforation before lead extraction.Saori AsadaNobuhiro NishiiTakayoshi ShinyaAkihito MiyoshiYoshimasa MorimotoMasakazu MiyamotoKoji NakagawaKazufumi NakamuraHiroshi MoritaHiroshi Ito<h4>Purpose</h4>High-risk patients can be identified by preprocedural computed tomography (CT) before lead extraction. However, CT evaluation may be difficult especially for lead tip identification due to artifacts in the leads. Selective right ventriculography (RVG) may enable preprocedural evaluation of lead perforation. We investigated the efficacy of RVG for identifying right ventricular (RV) lead perforation compared with CT in patients who underwent lead extraction.<h4>Methods</h4>Ninety-five consecutive patients who were examined by thin-section non-ECG-gated multidetector CT and RVG before lead extraction were investigated retrospectively. Newly recognized pericardial effusion after lead extraction was used as a reference standard for lead perforation. We analyzed the prevalence of RV lead perforation diagnosed by each method. The difference in the detection rates of lead perforation by RVG and CT was evaluated.<h4>Results</h4>Of the 115 RV leads in the 95 patients, lead perforation was diagnosed for 35 leads using CT, but the leads for 29 (83%) of those 35 leads diagnosed as lead perforation by CT were shown to be within the right ventricle by RVG. Three patients with 5 leads could not be evaluated by CT due to motion artifacts. The diagnostic accuracies of RVG and CT were significantly different (p < 0.001). There was no complication of pericardial effusion caused by RV lead extraction.<h4>Conclusion</h4>RVG for identification of RV lead perforation leads to fewer false-positives compared to non-ECG-gated CT. However, even in cases in which lead perforation is diagnosed, most leads may be safely extracted by transvenous lead extraction.https://doi.org/10.1371/journal.pone.0245502 |
| spellingShingle | Saori Asada Nobuhiro Nishii Takayoshi Shinya Akihito Miyoshi Yoshimasa Morimoto Masakazu Miyamoto Koji Nakagawa Kazufumi Nakamura Hiroshi Morita Hiroshi Ito Usefulness of right ventriculography compared with computed tomography for ruling out the possibility of lead perforation before lead extraction. PLoS ONE |
| title | Usefulness of right ventriculography compared with computed tomography for ruling out the possibility of lead perforation before lead extraction. |
| title_full | Usefulness of right ventriculography compared with computed tomography for ruling out the possibility of lead perforation before lead extraction. |
| title_fullStr | Usefulness of right ventriculography compared with computed tomography for ruling out the possibility of lead perforation before lead extraction. |
| title_full_unstemmed | Usefulness of right ventriculography compared with computed tomography for ruling out the possibility of lead perforation before lead extraction. |
| title_short | Usefulness of right ventriculography compared with computed tomography for ruling out the possibility of lead perforation before lead extraction. |
| title_sort | usefulness of right ventriculography compared with computed tomography for ruling out the possibility of lead perforation before lead extraction |
| url | https://doi.org/10.1371/journal.pone.0245502 |
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