Department of Pathology, Faculty Hospital St Ann and Masaryk University, 53, Pekařská Street, 656 91 Brno, Czech Republic.
Europace. 2012 Jan;14(1):117-23. doi: 10.1093/europace/eur274. Epub 2011 Sep 4.
To analyse histological findings surrounding the electrodes in pacemaker/implantable cardioverter-defibrillator (PM/ICD) patients. To compare histology around steroid-eluting and non-steroid ventricular pacing electrodes.
In autopsied PM/ICD patients histopathological findings around the electrodes were determined. Seventy patients were studied, PM(58), ICD(12), mean age 75.1 ± 9.3 years. The implantation-death interval was 4.0 ± 3.3 years. Most causes of death were cardiac (PM 52%, ICD 58%). The majority of atrial electrodes were attached to the endocardium and most ventricular electrodes were found in the myocardium (P ≤ 0.001). The maximum thickness of the fibrous electrode sheath was greatest for the ICD ventricular electrodes. Some electrodes were covered with fibrin thrombi and granulation tissue, most frequently in the ICD ventricular electrodes. The fibrous sheath usually contained chronic inflammatory cells and in some cases particles of foreign material, foreign body giant cells, and haematogenous pigment. The tissue around steroid-eluting ventricle PM electrodes was compared with the tissue around the non-steroid-eluting ventricle PM electrodes; granulation tissue, foreign material, giant cells being found more frequently around the steroid-eluting electrodes. The fibrous sheath was slightly thinner in the steroid-eluting electrodes. The histology around four coronary sinus electrodes was described.
Atrial electrodes were attached more superficially to the endocardium while PM and ICD ventricular electrodes were more frequently embedded in the myocardium. The electrodes were covered by a connective tissue sheath as a result of thrombus organization. This process persisted most frequently around ICD ventricular electrodes. Only borderline differences were found between the histological findings around steroid-eluting and non-steroid-eluting PM ventricular electrodes.
分析心脏起搏器/植入式心律转复除颤器（PM/ICD）患者电极周围的组织学发现。比较激素洗脱和非激素心室起搏电极周围的组织学。
在 PM/ICD 患者的尸检中确定了电极周围的组织病理学发现。研究了 70 名患者，PM（58 例），ICD（12 例），平均年龄 75.1±9.3 岁。植入-死亡间隔为 4.0±3.3 年。大多数死亡原因是心脏原因（PM 占 52%，ICD 占 58%）。大多数心房电极附着于心内膜，大多数心室电极位于心肌中（P≤0.001）。ICD 心室电极的纤维电极鞘的最大厚度最大。一些电极被纤维蛋白血栓和肉芽组织覆盖，在 ICD 心室电极中最常见。纤维鞘通常包含慢性炎症细胞，在某些情况下包含异物颗粒、异物巨细胞和血源性色素。比较激素洗脱心室 PM 电极周围的组织与非激素洗脱心室 PM 电极周围的组织；在激素洗脱电极周围更频繁地发现肉芽组织、异物、巨细胞。激素洗脱电极中的纤维鞘稍薄。描述了四个冠状窦电极周围的组织学。
心房电极更浅地附着于心内膜，而 PM 和 ICD 心室电极更频繁地嵌入心肌中。电极被血栓组织形成的结缔组织鞘覆盖。这一过程在 ICD 心室电极周围最常见。在激素洗脱和非激素洗脱 PM 心室电极周围的组织学发现之间仅发现了边缘差异。
