Abstract
Background and Objectives: There is currently no method that can be used for a precise evaluation of pacemaker leads using X-ray images, which could be a valuable add-on in the follow-up of patients. The aim of this paper was to create a simple method to measure selected points and lines using the chest radiography of patients with cardiac pacemakers. Materials and Methods: The study included 99 patients after permanent pacemaker implantation (72.0 ± 12.9 y; 58 W). The newly created method was used to evaluate the course of the leads based on an X-ray of the chest in an AP (posterior–anterior) projection (standing up) with optimization. The chest X-ray was applied to the original measurement grid, which was determined by specific anatomical points. For the purpose of this paper, a number of measurable parameters have been proposed. Results: The technical quality of the images was very good (4.50 ± 0.72). There were no gender-specific differences: women 4.46 ± 0.75/men 4.56 ± 0.67; p = 0.5183. The quality of the imaging of the leads was also good (3.72 ± 0.83), and no statistical differences were found between the genders. After verifying the technical quality of the X-ray images, the tract of the leads was measured. The only significant difference was found in parameter E—this value describing the so-called “death bend”, which was significantly lower in women (3.98 ± 1.35) vs. men (4.58 ± 1.49): p = 0.039. Conclusions: The presented method permitted the leads of a cardiac pacemaker to be precisely described with good clinical validity using chest radiography.
Highlights
An artificial pacemaker is a device that is used for the electrical correction of the heart beat [1,2]
The guidelines of the European Society of Cardiology are the basis for cardiac pacemaker implantation
For all of the patients who were included into the study, chest radiography was performed for clinical reasons
Summary
An artificial pacemaker is a device that is used for the electrical correction of the heart beat [1,2]. During the procedure, using the intracardiac signal that is obtained from the leads, the resistance and the pacing threshold are measured. These measurements enable the operator/surgeon to confirm the accuracy of implantation. In a small percentage of cases, complications may occur during surgery or sometimes after it because the implantation of a cardiac pacemaker is fraught with unlikely but serious risks. These include early complications such as the formation of a hematoma at the pacemaker site, the occurrence of pneumothorax or the dislocation of the leads in the heart. X-ray diagnostics is the preferred method due to its dissemination, acceptable quality and, most importantly, the safety of the patient and the implanted devices [5]
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