{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T15:29:56Z","timestamp":1775057396770,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,8]],"date-time":"2020-10-08T00:00:00Z","timestamp":1602115200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Physio Funct Imaging"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The constant interaction between intracardiac leads and the heart and veins results in excessive accumulation of fibrous connective tissue around the leads. The extent of this pathological phenomenon, which is visible on transesophageal echocardiography (TEE), and predisposing factors are not well defined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined 936 transesophageal echocardiograms prior to transvenous lead extraction (TLE) performed at a high\u2010volume centre between 2015 and 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The most important echocardiographic findings were fibrous binding sites between leads and cardiovascular structures, lead\u2010to\u2010lead adhesions, excessive lead loops, lead\u2010dependent tricuspid dysfunction (LDTD), asymptomatic masses on endocardial leads (AMEL) and vegetations. Fibrotic reaction within the walls of the heart and veins correlated with the presence of lead loops (OR\u00a0=\u00a01.771; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01) and lead dwell time (OR\u00a0=\u00a01.111; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). Women were more likely to have excessive lead loops (OR\u00a0=\u00a01.639; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01), and the occurrence of loops increase with the number of implanted leads (OR\u00a0=\u00a02.557; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001). Heart failure (OR\u00a0=\u00a04.016; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001), lead looping (OR\u00a0=\u00a02.603; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.01) and longer cumulative lead dwell time (OR\u00a0=\u00a01.017; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.05) increased the likelihood of LDTD. A variety of AMEL were identified in this study, most commonly in patients with older leads (OR\u00a0=\u00a01.043; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lead dwell time is the main factor predisposing to the occurrence of most lead\u2010associated phenomena visualized by TEE in patients with cardiac implantable electronic devices (CIED). Excessive looping of the lead is an important cause of fibrous binding sites and LDTD. AMEL are frequently detected in CIED patients, and their various forms concurrent with vegetations could represent an evolutionary stage of lead\u2010associated masses.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cpf.12662","type":"journal-article","created":{"date-parts":[[2020,9,19]],"date-time":"2020-09-19T00:59:21Z","timestamp":1600477161000},"page":"25-41","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Echocardiographic findings in patients with cardiac implantable electronic devices\u2014analysis of factors predisposing to lead\u2010associated changes"],"prefix":"10.1111","volume":"41","author":[{"given":"Dorota","family":"Nowosielecka","sequence":"first","affiliation":[{"name":"Department of Cardiology The Pope John Paul II Province Hospital Zamosc Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6632-6551","authenticated-orcid":false,"given":"Anna","family":"Polewczyk","sequence":"additional","affiliation":[{"name":"Department of Physiology and Patophysiology Collegium Medicum The Jan Kochanowski University Kielce Poland"},{"name":"Department of Cardiac Surgery Swietokrzyskie Cardiology Center Kielce Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wojciech","family":"Jache\u0107","sequence":"additional","affiliation":[{"name":"2nd Department of Cardiology Medical University of Silesia Zabrze Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u0141ukasz","family":"Tu\u0142ecki","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery The Pope John Paul II Province Hospital Zamosc Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrzej","family":"Kleinrok","sequence":"additional","affiliation":[{"name":"Department of Cardiology The Pope John Paul II Province Hospital Zamosc Poland"},{"name":"University of Information Technology and Management Rzeszow Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrzej","family":"Kutarski","sequence":"additional","affiliation":[{"name":"Department of Cardiology Medical University Lublin Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12530"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.08.019"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euy050"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx080"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn461"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2014.01.016"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.4065\/74.2.120"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.02.055"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euu137"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2011.03034.x"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2011.03.001"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2008.01.006"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbm.10306"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0000000000000797"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-304673"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.13173"},{"issue":"1","key":"e_1_2_7_18_1","doi-asserted-by":"crossref","first-page":"S135","DOI":"10.1111\/j.1540-8159.2008.02269.x","article-title":"Tricuspid incompetence following permanent pacemaker implantation","volume":"32","author":"Klutstein M.","year":"2009","journal-title":"Pacing and Clinical Electrophysiology"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eur384"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.09.001"},{"issue":"7","key":"e_1_2_7_21_1","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.1111\/jce.14244","article-title":"Hands on: How to approach patients undergoing lead extraction","volume":"31","author":"Lewis R. 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