title: Complications of Cardiac Perforation and Lead Dislodgement with an MRI-Conditional Pacing Lead: a Korean Multi-Center Experience.
abstract: Medtronic CapSureFix MRI 5086 pacing lead (5086; Medtronic, Inc., Minneapolis, MN, USA) has been reported to be associated with increased cardiac perforation and lead dislodgement. This study aimed to compare the incidence of cardiac perforation and lead dislodgement within 30 days after pacemaker implantation between 5086 MRI lead and previous Medtronic CapSureFix Novus 5076 non-MRI pacing lead. This was a nationwide, multicenter retrospective study in which we compared the incidence of adverse events between 277 patients implanted with 5086 lead and 205 patients implanted with 5076 lead between March 2009 and September 2014. Cardiac perforation within 30 days of pacemaker implantation occurred in 4 patients (1.4%) with the 5086 lead and in no patient with the 5076 lead (P = 0.084). Lead dislodgement occurred in 8 patients (2.9%) with the 5086 lead and in 5 patients (2.4%) with the 5076 lead (P = 0.764). On multivariate logistic regression analysis, age was significantly associated with cardiac perforation. Congestive heart failure and implantation of right atrial (RA) lead at RA free wall or septum were significant factors for the incidence of lead dislodgement and lead revision. The incidence of cardiac perforation and lead dislodgement were not statistically different between the patients with 5086 lead and the patients with 5076 lead. However, careful attention for cardiac perforation may be needed when using the 5086 MRI lead, especially in elderly patients.
authors: Division of Cardiology, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
authors: Chang Hee
authors: http://orcid.org/0000-0001-8716-1146
authors: CH
authors: Kwon
authors: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Jin Hee
authors: http://orcid.org/0000-0003-2774-3851
authors: JH
authors: Choi
authors: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. mdjunkim@gmail.com.
authors: Jun
authors: http://orcid.org/0000-0002-3573-638X
authors: J
authors: Kim
authors: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Uk
authors: http://orcid.org/0000-0001-8860-851X
authors: U
authors: Jo
authors: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Ji Hyun
authors: http://orcid.org/0000-0002-7162-1248
authors: JH
authors: Lee
authors: Division of Cardiology, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea.
authors: Woo Seok
authors: http://orcid.org/0000-0003-0250-1266
authors: WS
authors: Lee
authors: Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
authors: Yoo Ri
authors: http://orcid.org/0000-0003-4218-6424
authors: YR
authors: Kim
authors: Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors: Soo Yong
authors: http://orcid.org/0000-0002-1140-0910
authors: SY
authors: Lee
authors: Division of Cardiology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors: Ki Won
authors: http://orcid.org/0000-0002-1372-330X
authors: KW
authors: Whang
authors: Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Jihyun
authors: http://orcid.org/0000-0003-1782-2214
authors: J
authors: Yang
authors: Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Sung Hwan
authors: http://orcid.org/0000-0001-6805-0416
authors: SH
authors: Kim
authors: Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Yong Seog
authors: http://orcid.org/0000-0003-3567-6505
authors: YS
authors: Oh
authors: Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Kyoung Min
authors: http://orcid.org/0000-0002-8406-3142
authors: KM
authors: Park
authors: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Gi Byoung
authors: http://orcid.org/0000-0003-4391-5406
authors: GB
authors: Nam
authors: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Kee Joon
authors: http://orcid.org/0000-0002-9055-049X
authors: KJ
authors: Choi
authors: Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: You Ho
authors: http://orcid.org/0000-0003-0063-6300
authors: YH
authors: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects*; D004567:Electrodes, Implanted; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D056910:Republic of Korea; D012189:Retrospective Studies
keywords: Cardiac Perforation; Complications; Magnetic Resonance Imaging; Pacemaker