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01-02-2019 | Cardiac

Assessment of Cardiac Lead Perforation: Comparison Among Chest Radiography, Transthoracic Echocardiography and Electrocardiography-gated Contrast-enhanced Cardiac CT

Authors: Xiang Zhang, Chushan Zheng, Peiwei Wang, Dongye Wang, Boshui Huang, Guozhao Li, Huijun Hu, Zehong Yang, Xiaohui Duan, Shaoxin Zheng, Pinming Liu, Jingfeng Wang, Jun Shen

Published in: European Radiology | Issue 2/2019

Abstract

Objectives

Cardiac lead perforation is a rare but potentially life-threatening event. The purpose of this study was to investigate the diagnostic performances of chest radiography, transthoracic echocardiography (TTE) and electrocardiography (ECG)-gated contrast-enhanced cardiac CT in the assessment of cardiac lead perforation.

Methods

This retrospective study was approved by the ethics review board of Sun Yat-Sen Memorial Hospital at Sun Yat-Sen University (Guangzhou, China), and the need to obtain informed consent was waived. Between May 2010 and Oct 2017, 52 patients were clinically suspected to have a cardiac lead perforation and received chest radiography, TTE and ECG-gated contrast-enhanced cardiac CT. Among them, 13 patients were identified as having cardiac lead perforation. The diagnostic performances of these three modalities were evaluated by receiver-operating characteristic (ROC) curves using a composite reference standard of surgical and electrophysiological results and clinical follow-up. The areas under ROCs (AUROCs) were compared with the McNemar test.

Results

The accuracies of chest radiography, TTE and ECG-gated contrast-enhanced cardiac CT imaging for the diagnosis of cardiac lead perforation were 73.1%, 82.7% and 98.1%, respectively. ECG-gated contrast-enhanced cardiac CT had a higher AUROC than chest radiography (p < 0.001) and TTE (p < 0.001).

Conclusions

ECG-gated contrast-enhanced cardiac CT is superior to both chest radiography and TTE imaging for the assessment of cardiac lead perforation.

Key Points

• ECG-gated contrast-enhanced cardiac CT has an accuracy of 98.1% in the diagnosis of cardiac lead perforation.

• The AUROC of ECG-gated contrast-enhanced cardiac CT is higher than those of chest radiography and TTE imaging.

• ECG-gated contrast-enhanced cardiac CT imaging has better diagnostic performance than both chest radiography and TTE imaging for the assessment of cardiac lead perforation.

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Title: Assessment of Cardiac Lead Perforation: Comparison Among Chest Radiography, Transthoracic Echocardiography and Electrocardiography-gated Contrast-enhanced Cardiac CT
Authors: Xiang Zhang
Chushan Zheng
Peiwei Wang
Dongye Wang
Boshui Huang
Guozhao Li
Huijun Hu
Zehong Yang
Xiaohui Duan
Shaoxin Zheng
Pinming Liu
Jingfeng Wang
Jun Shen
Publication date: 01-02-2019
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 2/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5633-6

ACC 2024 Congress

Springer Medicine

Assessment of Cardiac Lead Perforation: Comparison Among Chest Radiography, Transthoracic Echocardiography and Electrocardiography-gated Contrast-enhanced Cardiac CT

Abstract

Objectives

Methods

Results

Conclusions

Key Points

ACC 2024 Congress

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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