In recent years, pacemaker lead failure due to compressive damage has been reported with increasing frequency. To document the mechanism of this failure, we evaluated explanted mechanically damaged leads with electrical testing, optical microscopy, and in some cases, scanning electron microscopy (SEM) In addition, we performed an autopsy study to measure the compressive loads on catheters placed percutaneously through the costoclavicular angle, as well as by cephalic cutdown. Of the 49 explanted compression damaged leads with enough clinical data for analysis, all had been placed by percutaneous subclavian puncture. Our autopsy data confirmed the significant increase in pressures generated in the costoclavicular angle for medial percutaneous subclavian catheterization (126 ± 26 mmHg) compared to a more lateral percutaneous subclavian puncture (63 ± 15 mmHg) or a cephalic cutdown (38 ± 13 mmHg) (P &lt; 0.01). In vivo coil compression testing documented loads up to 100 pounds per linear inch of coil and a compressive morphology by SEM identical to that seen in the clinical explants. Pacemaker leads appear to be susceptible to compression damage when placed by subclavian venipuncture. When possible, leads should be placed such that they avoid the tight costoclavicular angle.

DONALD M. JACOBS

ANDREW S. FINK

ROBERT P. MILLER

W. ROBERT ANDERSON

RICK D. MCVENES

JOSEPH F. LESSAR

KENNETH E. COBIAN

DALE B. STAFFANSON

JAMES E. UPTON

MELVIN P. BUBRICK

Pacing and Clinical Electrophysiology

Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.

PACE - Pacing and Clinical Electrophysiology is the leading peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in this area. The journal features original research, reviews, didactic papers, and case reports relevant to daily practice. Additionally, it includes editorials, book reviews, reflections on humane topics related to medical practice, electrophysiology (EP) rounds, device rounds, and information regarding the quality of devices used in the specialty.

《PACE - Pacing and Clinical Electrophysiology》是心脏起搏和植入式心脏复律除颤领域的顶尖同行评审期刊，发表了该领域超过50%的英文文章。期刊内容包括原创研究、综述、教学论文和与日常实践相关的病例报告。此外，文章还包括社论、书评、与医学实践相关的人文主题思考、电生理（EP）讨论、设备讨论，以及有关该专业使用设备质量的信息。

PACE - Pacing and Clinical Electrophysiology

Anatomical and Morphological Evaluation of Pacemaker Lead Compression

Pacemaker leads appear to be susceptible to compression damage when placed by subclavian venipuncture, and when possible, leads should be placed such that they avoid the tight costoclavicular angle.

Category	Quartile
医学	4
医学, 心脏和心血管系统	4
医学, 工程生物医学	4

Anatomical and Morphological Evaluation of Pacemaker Lead Compression

ivySCI AI Smartly Parses PDF, Answers Researchers' Questions, and Helps You Understand Papers in Seconds

Journal Info

Category	Quartile
ENGINEERING, BIOMEDICAL	3