Abstract
Fixation of the pacemaker leads during pacemaker implantation leads to an increase of cardiac Troponin T (cTnT) that can be interpreted as a sign of minimal myocardial damage. This trial evaluates whether the mechanism type of lead fixation influences the magnitude of cTnT release. Patients having a de-novo cardiac pacemaker implantation or a lead revision were centrally randomized to receive either a ventricular lead with an active (screw) or passive (tine) fixation mechanism. High-sensitive Troponin T (hsTnT) was determined on the day of the procedure beforehand and on the following day. 326 Patients (median age (IQR) 75.0 (69.0–80.0) years, 64% male) from six international centers were randomized to receive ventricular leads with an active (n = 166) or passive (n = 160) fixation mechanism. Median (IQR) hsTnT levels increased by 0.009 (0.004–0.021) ng/ml in the group receiving screw-in ventricular leads and by 0.008 (0.003–0.030) ng/ml in the group receiving tined ventricular leads (n.s.). In conclusion pacemaker implantations are followed by a release of hsTnT. The choice between active or passive fixation ventricular leads does not have a significant influence on the extent of myocardial injury and the magnitude of hsTnT release.
Highlights
Data on serum Troponin levels following pacemaker implantation is limited to the evaluation of absolute serum levels of standard Troponin I3–5 and lacks information on the currently preferred high sensitive Troponin www.nature.com/scientificreports/
The aim of the present trial is to compare the magnitude of the implantation-related serum high sensitive Troponin T release in a larger number of patients receiving either an active fixation or a passive fixation ventricular lead
Patients who suffered from conditions that might be affiliated with an elevation or fluctuation of cardiac troponin levels were excluded: patients in NYHA IV or in cardiogenic shock, patients scheduled for cardioversion within 24 hours after the procedure and patients with a history of pulmonary embolism, dialysis, heart surgery, acute coronary syndrome, revascularizations, cardioversions or ablations within four weeks of the pacemaker implantation in which high sensitive Troponin T (hsTnT) serum levels proved to be above the reference value
Summary
Data on serum Troponin levels following pacemaker implantation is limited to the evaluation of absolute serum levels of standard Troponin I3–5 and lacks information on the currently preferred high sensitive Troponin www.nature.com/scientificreports/. Apart from one small, non-randomized study, these evaluations did not address the potential effect of different lead types[7]. The aim of the present trial is to compare the magnitude of the implantation-related serum high sensitive Troponin T (hsTnT) release in a larger number of patients receiving either an active fixation or a passive fixation ventricular lead
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