ArticleCirculation2013
Stroke or transient ischemic attack in patients with transvenous pacemaker or defibrillator and echocardiographically detected patent foramen ovale.
Article in Circulation, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 98 citations in OpenAlex.
- Paradoxical embolism from a migrated right atrial 'lead ghost' through an unrecognized patent foramen ovale after cardiac resynchronization therapy-defibrillator lead extraction: a case report.European heart journal. Case reports · 2026Article
- A Constellation of Stroke and Hypoxemia Post ICD Lead Extraction: Role of Patent Foramen Ovale.Arquivos brasileiros de cardiologia · 2024Article
- Changes in cerebral autoregulation, stroke-related blood biomarkers, and autonomic regulation after patent foramen ovale closure in severe migraine patients.CNS neuroscience & therapeutics · 2023Article
- Non-traditional implantable cardioverter-defibrillator configurations and insertion techniques: a review of contemporary options.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2022Review
- Long-Term Survival of Patients With Left Ventricular Noncompaction.Journal of the American Heart Association · 2021Article
- State-of-the-Art Review: Anatomical and Imaging Considerations During Transcatheter Tricuspid Valve Repair Using an Annuloplasty Approach.Frontiers in cardiovascular medicine · 2021Review
- Chronic thromboembolic pulmonary hypertension secondary to implantable cardioverter defibrillator lead thrombus in a patient with Brugada syndrome: a rare complication requiring a multidisciplinary approach.BMJ case reports · 2020Article
- Interaction of cardiac implantable electronic device and patent foramen ovale in ischemic stroke: A case-only study.Pacing and clinical electrophysiology : PACE · 2019Article
- Nanostim-leadless pacemaker.Herzschrittmachertherapie & Elektrophysiologie · 2018Review
- Iatrogenic atrial septal defect: reassurance or inquisitiveness.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2018Article
- Concomitant coronary and pulmonary embolism associated with patent foramen ovale: A case report.Medicine · 2017Article
- Use of a cerebral protection device for the laser extraction of a pacemaker lead traversing a patent foramen ovale.HeartRhythm case reports · 2017Article
- A Novel Defibrillation Tool: Percutaneously Delivered, Partially Insulated Epicardial Defibrillation.JACC. Clinical electrophysiology · 2017Article
- Endocardial Device Leads in Patients with Patent Foramen Ovale: Echocardiographic Correlates of Stroke/TIA and Mortality.Pacing and clinical electrophysiology : PACE · 2017Article
- Cardiac implantable electronic device lead-based masses and atrial fibrillation ablation: a case-based illustration of periprocedural anticoagulation management strategies.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2016Article
- Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management.European journal of pediatrics · 2016Review
- Mobile thrombus on cardiac implantable electronic device leads of patients undergoing cardiac ablation: incidence, management, and outcomes.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2016Article
- Ischemic Stroke or Systemic Embolism After Transseptal Ablation of Arrhythmias in Patients With Cardiac Implantable Electronic Devices.Journal of the American Heart Association · 2016Article
- Acute stroke from paradoxical embolism of dense fibrous tissue following pacemaker lead extraction: salvation by mechanical thrombectomy.Clinical case reports · 2016Article
- Pulmonary embolism in patients with transvenous cardiac implantable electronic device leads.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2016Observational
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Authors and funding
13 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA patent foramen ovale (PFO) may permit arterial embolization of thrombi that accumulate on the leads of cardiac implantable electronic devices in the right-sided cardiac chambers. We sought to determine whether a PFO increases the risk of stroke/transient ischemic attack (TIA) in patients with endocardial leads. METHODS AND
resultsWe retrospectively evaluated all patients who had endocardial leads implanted between January 1, 2000, and October 25, 2010, at Mayo Clinic Rochester. Echocardiography was used to establish definite PFO and non-PFO cohorts. The primary end point of stroke/TIA consistent with a cardioembolic etiology and the secondary end point of mortality during postimplantation follow-up were compared in PFO versus non-PFO patients with the use of Cox proportional hazards models. We analyzed 6075 patients (364 with PFO) followed for a mean 4.7 ± 3.1 years. The primary end point of stroke/TIA was met in 30/364 (8.2%) PFO versus 117/5711 (2.0%) non-PFO patients (hazard ratio, 3.49; 95% confidence interval, 2.33-5.25; P<0.0001). The association of PFO with stroke/TIA remained significant after multivariable adjustment for age, sex, history of stroke/TIA, atrial fibrillation, and baseline aspirin/warfarin use (hazard ratio, 3.30; 95% confidence interval, 2.19-4.96; P<0.0001). There was no significant difference in all-cause mortality between PFO and non-PFO patients (hazard ratio, 0.91; 95% confidence interval, 0.77-1.07; P=0.25).
conclusionsIn patients with endocardial leads, the presence of a PFO on routine echocardiography is associated with a substantially increased risk of embolic stroke/TIA. This finding suggests a role of screening for PFOs in patients who require cardiac implantable electronic devices; if a PFO is detected, PFO closure, anticoagulation, or nonvascular lead placement may be considered.
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