TY - JOUR
T1 - Usefulness of intracardiac echocardiography for the diagnosis of cardiovascular implantable electronic device-related endocarditis
AU - Narducci, Maria Lucia
AU - Pelargonio, Gemma
AU - Russo, Eleonora
AU - Marinaccio, Leonardo
AU - Di Monaco, Antonio
AU - Perna, Francesco
AU - Bencardino, Gianluigi
AU - Casella, Michela
AU - Di Biase, Luigi
AU - Santangeli, Pasquale
AU - Palmieri, Rosalinda
AU - Lauria, Christian
AU - Al Mohani, Ghaliah
AU - Di Clemente, Francesca
AU - Tondo, Claudio
AU - Pennestri, Faustino
AU - Ierardi, Carolina
AU - Rebuzzi, Antonio G.
AU - Crea, Filippo
AU - Bellocci, Fulvio
AU - Natale, Andrea
AU - Russo, Antonio Dello
N1 - Funding Information:
Dr. Tondo has served as a member of the advisory board of Biosense Webster; and has been a consultant for, and received lecture fees from, St. Jude Medical. Dr. Natale has received compensation for belonging to the speakers' bureau for St. Jude Medical, Boston Scientific, Medtronic, and Biosense Webster; and has received a research grant from St. Jude Medical . Dr. Natale is also a consultant for Biosense Webster. Dr. Di Biase is a consultant for Hansen Medical and Biosense Webster. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. The first 2 authors contributed equally to this work.
PY - 2013/4/2
Y1 - 2013/4/2
N2 - Objectives: The goal of this study was to compare transesophageal echocardiography (TEE) and intracardiac echocardiography (ICE) for the diagnosis of cardiac device-related endocarditis (CDI). Background: The diagnosis of infective endocarditis (IE) was established by using the modified Duke criteria based mainly on echocardiography and blood culture results. No previous studies have compared ICE with TEE for the diagnosis of IE. Methods: We prospectively enrolled 162 patients (age 72 ± 11 years; 125 male) who underwent transvenous lead extraction: 152 with CDI and 10 with lead malfunction (control group). Using the modified Duke criteria, we divided the patients with infection into 3 groups: 44 with a "definite" diagnosis of IE (group 1), 52 with a "possible" diagnosis of IE (group 2), and 56 with a "rejected" diagnosis of IE (group 3). TEE and ICE were performed before the procedure. Results: In group 1, ICE identified intracardiac masses (ICM) in all 44 patients; TEE identified ICM in 32 patients (73%). In group 2, 6 patients (11%) had ICE and TEE both positive for ICM, 8 patients (15%) had a negative TEE but a positive ICE, and 38 patients (73%) had ICE and TEE both negative. In group 3, 2 patients (3%) had ICM both at ICE and TEE, 1 patient (2%) had an ICM at ICE and a negative TEE, and 53 patients (95%) had no ICM at ICE and TEE. ICE and TEE were both negative in the control group. Conclusions: ICE represents a useful technique for the diagnosis of ICM, thus providing improved imaging of right-sided leads and increasing the diagnostic yield compared with TEE.
AB - Objectives: The goal of this study was to compare transesophageal echocardiography (TEE) and intracardiac echocardiography (ICE) for the diagnosis of cardiac device-related endocarditis (CDI). Background: The diagnosis of infective endocarditis (IE) was established by using the modified Duke criteria based mainly on echocardiography and blood culture results. No previous studies have compared ICE with TEE for the diagnosis of IE. Methods: We prospectively enrolled 162 patients (age 72 ± 11 years; 125 male) who underwent transvenous lead extraction: 152 with CDI and 10 with lead malfunction (control group). Using the modified Duke criteria, we divided the patients with infection into 3 groups: 44 with a "definite" diagnosis of IE (group 1), 52 with a "possible" diagnosis of IE (group 2), and 56 with a "rejected" diagnosis of IE (group 3). TEE and ICE were performed before the procedure. Results: In group 1, ICE identified intracardiac masses (ICM) in all 44 patients; TEE identified ICM in 32 patients (73%). In group 2, 6 patients (11%) had ICE and TEE both positive for ICM, 8 patients (15%) had a negative TEE but a positive ICE, and 38 patients (73%) had ICE and TEE both negative. In group 3, 2 patients (3%) had ICM both at ICE and TEE, 1 patient (2%) had an ICM at ICE and a negative TEE, and 53 patients (95%) had no ICM at ICE and TEE. ICE and TEE were both negative in the control group. Conclusions: ICE represents a useful technique for the diagnosis of ICM, thus providing improved imaging of right-sided leads and increasing the diagnostic yield compared with TEE.
KW - infective endocarditis
KW - intracardiac echocardiography
KW - transesophageal echocardiography
KW - transvenous lead extraction
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U2 - 10.1016/j.jacc.2012.12.041
DO - 10.1016/j.jacc.2012.12.041
M3 - Article
C2 - 23500279
AN - SCOPUS:84875469382
SN - 0735-1097
VL - 61
SP - 1398
EP - 1405
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 13
ER -