الفهرس 
Introductionيوجد فقط 14 صفحة متاحة للعرض العام
 |  | from | 87 |  |  |
| | | from | 87 | | |
المستخلص
The term myocardial injury should be used when there is evidence of elevated cardiac troponin values (cTn) with at least one value above the 99th percentile upper reference limit (URL). The myocardial injury is considered acute if there is a rise and/or fall of cTn values.
The cardiac troponin I (cTnI) is a part of the cardiac contractile apparatus, the troponin-tropomyosin complex. It is a very sensitive laboratory marker of myocardial cell necrosis and one of the gold standard measurements in detecting myocardial injury. Elevated cTnI levels maybe associated with a variety of clinical conditions like myocardial infarction, acute pulmonary edema, ventricular tachycardia, shock, acute renal impairment
The aim of the study is to assess the extent of myocardial injury in patients undergoing trans-venous implantation of permanent pacemaker using cardiac troponin I (cTnI) as a marker of myocardial injury and it’s relation to different sites of RV pacing and number of trials of screwing the RV lead into the myocardium.
This study included 50 patients undergoing trans-venous Implantation of single or dual chamber permanent pacemakers divided into 2 equal groups according to the site of RV lead implantation, 25 patients in RV lead implanted in the Apex and 25 patients RV lead implanted in the Septum.
The study was carried out at Ain Shams University hospitals.
In the current study there was statistically significant relationship between the site of RV lead implantation and number of screwing and extent of myocardial injury. Being higher in the septal group and with increased number of screwing.
There was statistically significant relationship between pacemaker implantation in all patients regardless the site of RV lead and incidence of myocardial injury (P-value > 0.001).
We conclude that transvenous implantation of permanent pacemakers is associated with an increased incidence of myocardial injury and septal RV pacing is associated with more extent of myocardial injury than apical RV pacing. Also increasing number of trials of active fixation by screwing the RV leads into the myocardium is associated with more extent of myocardial injury.