Key result
Passive lead fixation is linked to higher 6-hour cTnI versus active fixation despite similar adverse events.
Why the study?
The effect of lead fixation type on the extent of myocardial injury and inflammation after permanent pacemaker implantation was not well characterized.
Does active lead fixation compared to passive lead fixation affect the extent of myocardial injury and inflammation in patients undergoing permanent pacemaker implantation?
Observational (n=101)
Does active lead fixation compared to passive lead fixation affect the extent of myocardial injury and inflammation in patients undergoing permanent pacemaker implantation?
The type of lead fixation during pacemaker implantation differentially affects early biomarker release (cTnI vs CRP), but these elevations do not correlate with worse short-term prognosis.
Lead fixation type affects early biomarker rises without linking to adverse events; leaves open optimal choice pending randomized confirmation.
BACKGROUND: Permanent pacemaker implantation is accompanied by minor myocardial damage, indicated by elevated serum levels of cardiac biomarkers. Aim of this prospective study was to comparably investigate the lead fixation type effect on the extent of myocardial injury and inflammation following pacemaker implantation, and to assess the possible clinical implications. METHODS: Cardiac troponin I (cTnI) and C-reactive protein (CRP) were measured at baseline, 6 and 24h after implantation in 101 patients, categorized into the active and passive lead fixation group. Patients were followed up for clinical adverse events or abnormal pacing parameters at 24h, 7 and 30 days post-procedure. RESULTS: cTnI increased at 6h post-procedure (p<0.05) in 23.8% of patients, and returned to baseline after 24h. The passive group demonstrated significantly higher cTnI at 6h compared to the active group (p=0.006). CRP increased significantly at 6h, and maintained an upward trend after 24h (p<0.01) in both groups. The active group demonstrated significantly higher CRP at 6h compared to the passive group. We did not identify an association of positive biomarkers with adverse events. CONCLUSION: cTnI and CRP can increase early after permanent pacemaker implantation, indicating mechanical myocardial injury and inflammation. The extent of these biomarkers elevation depends on the lead fixation type, and is not related to worse short-term prognosis.
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Dimitrios Varvarousis (2018) conducted an observational in Permanent pacemaker implantation (n=101). Active lead fixation vs. Passive lead fixation was evaluated on Cardiac troponin I (cTnI) and C-reactive protein (CRP) levels at 6h and 24h post-procedure (p=0.006). Passive lead fixation was associated with significantly higher cardiac troponin I at 6 hours post-implantation compared to active fixation (p=0.006), though neither was linked to adverse events.
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