CARDIAC IMPLANTABLE ELECTRONIC DEVICE LEAD PERFORATION RATES, MANAGEMENT AND OUTCOMES

BackgroundLead perforation after cardiovascular implantable electronic device (CIED) implant is an uncommon but well-recognized complication. There are no strong recommendations from society guidelines on management; indication for lead revision and pericardial drainage usually decided by the treating clinicians.Methods ResultsA prospective registry of all CIED procedures was started at our institution in January 2007. The had a specific focus prospectively identifying complications. Between April 2007 September 2019, 10290 patients received de novo implant; 3737 (36%) were cardioverter-defibrillators (ICD). 4704 atrial leads 6514 ventricular pacemaker implanted. We identified 43 potential perforations chart review, 27 confirmed included study. Patient characteristics management shown Table 1. Overall rate occurred 27/10920 implants (0.26%). 0.09%; there difference between ICD vs pacemakers (0.16% 0.25%, p=0.37). active passive (0.2% 0.16%, p=0.63). Perforation diagnosed mean 14.2±26.9 days following implant. Of patients, 13 (48%) underwent only, 4 (15%) pericardiocentesis 5 (19%) both revision. Five managed conservatively. Among with moderate or greater effusion, without pericardiocentesis. All 14 either parameter change diaphragmatic stimulation recurrent cases tamponade pulled back repositioned. In conservatively, unplanned interventions. Importantly, deaths, required sternotomy.Conclusion clinicians. Lead Methods sternotomy. A Conclusion