{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:34:38Z","timestamp":1791041678171,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,1,11]],"date-time":"2017-01-11T00:00:00Z","timestamp":1484092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Meta\u2010Analysis of Pacemaker Lead Perforation<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Two leadless pacemaker (PM) systems were recently developed to avoid pocket\u2010 and lead\u2010related complications. As leadless PMs are implanted with a large delivery catheter, cardiac perforation remains a major safety concern. We aimed to provide a literature review on incidence of cardiac perforation with conventional and with leadless PM systems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>A systematic review over the last 25 years for studies reporting data on PM lead perforation was performed. Findings were synthesized descriptively. Where control groups were available, data were meta\u2010analyzed to identify important clinical risk factors.<\/jats:p><jats:p>A total of 28 studies comprising 60,744 patients undergoing conventional PM implantation were analyzed. The incidence of lead perforation ranged from 0% to 6.37% (mean 0.82%, weighted mean 0.31%, median of 0.40%). There was no significant difference in perforation risk between atrial and ventricular electrodes (POR 0.72, 95% confidence interval [CI], 0.28\u20131.87, P = 0.50) and between MRI conditional and conventional leads (POR 5.93, 95% CI, 0.72\u201348.76, P = 0.10). The use of active fixation leads (POR 4.25, 95% CI, 1.00\u201317.95, P = 0.05) and utilization of DDD versus VVI PM systems (POR 3.50, 95% CI, 1.48\u20138.28, P &lt; 0.01) were associated with higher rates of perforation. In the 2 leadless PM studies, the incidence of cardiac perforation was 1.52% for each.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>PM lead perforation rates vary in individual studies with an overall low incidence. Leadless PMs seem to be associated with a slightly higher perforation risk, most likely reflecting a learning curve effect of this novel technology.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.13140","type":"journal-article","created":{"date-parts":[[2016,12,7]],"date-time":"2016-12-07T13:02:25Z","timestamp":1481115745000},"page":"336-346","source":"Crossref","is-referenced-by-count":78,"title":["Incidence of Cardiac Perforation With Conventional and With Leadless Pacemaker Systems: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"28","author":[{"given":"MATE","family":"VAMOS","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Hospital Frankfurt Goethe University  Frankfurt Am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JULIA W.","family":"ERATH","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Frankfurt Goethe University  Frankfurt Am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ALEXANDER P.","family":"BENZ","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Frankfurt Goethe University  Frankfurt Am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ZSOLT","family":"BARI","sequence":"additional","affiliation":[{"name":"Department of Cardiology Medical Centre, Hungarian Defence Forces  Budapest Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GABOR Z.","family":"DURAY","sequence":"additional","affiliation":[{"name":"Department of Cardiology Medical Centre, Hungarian Defence Forces  Budapest Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"STEFAN H.","family":"HOHNLOSER","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital Frankfurt Goethe University  Frankfurt Am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,1,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2007.00699.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20803"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12431"},{"key":"e_1_2_7_5_1","first-page":"357","article-title":"Delayed perforation of the right ventricle as a complication of permanent cardiac pacing\u2014is following the guidelines always the right choice? 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