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ID 61866
フルテキストURL
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著者
Asada, Saori Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences ORCID
Nishii, Nobuhiro Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kaken ID publons
Shinya, Takayoshi Department of Pediatric Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences ORCID researchmap
Miyoshi, Akihito Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Morimoto, Yoshimasa Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Miyamoto, Masakazu Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Nakagawa, Koji Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Nakamura, Kazufumi Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kaken ID publons researchmap
Morita, Hiroshi Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons researchmap
Ito, Hiroshi Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kaken ID
抄録
Purpose 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. Methods Ninety-five consecutive patients who were examined by thin-section non-ECG-gated multi-detector 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. Results 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. Conclusion 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.
発行日
2021-03-04
出版物タイトル
PLoS One
16巻
3号
出版者
Public Library of Science
開始ページ
e0245502
ISSN
1932-6203
資料タイプ
学術雑誌論文
言語
英語
OAI-PMH Set
岡山大学
著作権者
© 2021 Asada et al.
論文のバージョン
publisher
PubMed ID
NAID
DOI
Web of Science KeyUT
関連URL
isVersionOf https://doi.org/10.1371/journal.pone.0245502
ライセンス
https://creativecommons.org/licenses/by/4.0/
Citation
Asada S, Nishii N, Shinya T, Miyoshi A, Morimoto Y, Miyamoto M, Nakagawa K, Nakamura K, Morita H, Ito H. Usefulness of right ventriculography compared with computed tomography for ruling out the possibility of lead perforation before lead extraction. PLoS One. 2021 Mar 4;16(3):e0245502. doi: 10.1371/journal.pone.0245502. PMID: 33661956; PMCID: PMC7932068.