Hypersensitivity to material and environmental burden as a
possible cause of late complications of cardiac implantable
electronic devices

J 2018

Hypersensitivity to material and environmental burden as a possible cause of late complications of cardiac implantable electronic devices

MAŇOUSEK, Jan, Irena ANDRŠOVÁ, Vera STEJSKAL, Jitka VLAŠÍNOVÁ, Milan SEPŠI et. al.

Basic information

Original name

Hypersensitivity to material and environmental burden as a possible cause of late complications of cardiac implantable electronic devices

Authors

MAŇOUSEK, Jan (203 Czech Republic), Irena ANDRŠOVÁ (203 Czech Republic), Vera STEJSKAL (752 Sweden, belonging to the institution), Jitka VLAŠÍNOVÁ (203 Czech Republic), Milan SEPŠI (203 Czech Republic, guarantor, belonging to the institution), Jan KUTA (203 Czech Republic, belonging to the institution), Jana KLÁNOVÁ (203 Czech Republic, belonging to the institution), Michal MAZÍK (703 Slovakia), Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution), Lenka ŠNAJDROVÁ (203 Czech Republic, belonging to the institution), Klára BENEŠOVÁ (203 Czech Republic, belonging to the institution), Tomáš NOVOTNÝ (203 Czech Republic), Andrea ZADÁKOVÁ (203 Czech Republic) and Jindřich ŠPINAR (203 Czech Republic)

Edition

EP Europace, Oxford, Oxford University Press, 2018, 1099-5129

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 5.047

RIV identification code

RIV/00216224:14110/18:00104323

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1093/europace/eux227

UT WoS

000444551400003

Keywords in English

Pacemaker; Implantable cardioverter-defibrillator; Late complication; Metal pollutants; Delayed-type hypersensitivity; Lymphocyte transformation test

Abstract

V originále

Aims To evaluate whether patients with late complications of pacemakers or implantable cardioverter-defibrillators have hypersensitivity reactions to some of the materials used in generators or in electrodes, or to environmental metal burden. Methods and results The cohort consisted of 20 men and 4 women (mean age: 62.3 +/- 17.2 years) who had a history of late complications of implanted devices. The control group involved 25 men and 8 women (mean age: 64.6 +/- 14.0 years) who had comparable devices, but no history of late complications. Lymphocyte transformation test was used to evaluate hypersensitivity to eight metal pollutants (antimony, manganese, mercury, molybdenum, nickel, platinum, tin, and titanium) selected by results of questionnaires on environmental burden, and by material analysis of generators and electrode surfaces. Exposures to metal pollutants were approximately the same in patients and in controls. Titanium alloy used in generators contained at least 99.32% of titanium and trace levels of other metals; higher levels of tin and platinum were detected in electrode surfaces. Hypersensitivity reactions to mercury and tin were significantly more frequent in patients than in controls (patients and controls: mercury: 68.2 and 31.1%, respectively; P = 0.022; tin: 25.0 and 3.2%, respectively; P = 0.035). In contrast, hypersensitivity to manganese was significantly more frequent in controls than in patients (patients and controls: 13.6 and 50.0%, respectively; P = 0.008). Conclusion Our findings suggest a possible relation between hypersensitivity to metals used in implantable devices or to environmental metal burden and the occurrence of their late complications.

Links

ED2.1.00/19.0382, research and development project

Name: CETOCOEN UPgrade

LM2015051, research and development project

Name: Centrum pro výzkum toxických látek v prostředí (Acronym: RECETOX RI)

Investor: Ministry of Education, Youth and Sports of the CR

Citovat

MAŇOUSEK, Jan, Irena ANDRŠOVÁ, Vera STEJSKAL, Jitka VLAŠÍNOVÁ, Milan SEPŠI, Jan KUTA, Jana KLÁNOVÁ, Michal MAZÍK, Jiří JARKOVSKÝ, Lenka ŠNAJDROVÁ, Klára BENEŠOVÁ, Tomáš NOVOTNÝ, Andrea ZADÁKOVÁ and Jindřich ŠPINAR. Hypersensitivity to material and environmental burden as a possible cause of late complications of cardiac implantable electronic devices. EP Europace. Oxford: Oxford University Press, 2018, vol. 20, No 9, p. "E140"-"E147", 8 pp. ISSN 1099-5129. Available from: https://dx.doi.org/10.1093/europace/eux227.

@article{1461096,
   author = {Maňousek, Jan and Andršová, Irena and Stejskal, Vera and Vlašínová, Jitka and Sepši, Milan and Kuta, Jan and Klánová, Jana and Mazík, Michal and Jarkovský, Jiří and Šnajdrová, Lenka and Benešová, Klára and Novotný, Tomáš and Zadáková, Andrea and Špinar, Jindřich},
   article_location = {Oxford},
   article_number = {9},
   doi = {http://dx.doi.org/10.1093/europace/eux227},
   keywords = {Pacemaker; Implantable cardioverter-defibrillator; Late complication; Metal pollutants; Delayed-type hypersensitivity; Lymphocyte transformation test},
   language = {eng},
   issn = {1099-5129},
   journal = {EP Europace},
   title = {Hypersensitivity to material and environmental burden as a possible cause of late complications of cardiac implantable electronic devices},
   volume = {20},
   year = {2018}
}

TY  - JOUR
ID  - 1461096
AU  - Maňousek, Jan - Andršová, Irena - Stejskal, Vera - Vlašínová, Jitka - Sepši, Milan - Kuta, Jan - Klánová, Jana - Mazík, Michal - Jarkovský, Jiří - Šnajdrová, Lenka - Benešová, Klára - Novotný, Tomáš - Zadáková, Andrea - Špinar, Jindřich
PY  - 2018
TI  - Hypersensitivity to material and environmental burden as a possible cause of late complications of cardiac implantable electronic devices
JF  - EP Europace
VL  - 20
IS  - 9
SP  - "E140"-"E147"
EP  - "E140"-"E147"
PB  - Oxford University Press
SN  - 10995129
KW  - Pacemaker
KW  - Implantable cardioverter-defibrillator
KW  - Late complication
KW  - Metal pollutants
KW  - Delayed-type hypersensitivity
KW  - Lymphocyte transformation test
N2  - Aims To evaluate whether patients with late complications of pacemakers or implantable cardioverter-defibrillators have hypersensitivity reactions to some of the materials used in generators or in electrodes, or to environmental metal burden. Methods and results The cohort consisted of 20 men and 4 women (mean age: 62.3 +/- 17.2 years) who had a history of late complications of implanted devices. The control group involved 25 men and 8 women (mean age: 64.6 +/- 14.0 years) who had comparable devices, but no history of late complications. Lymphocyte transformation test was used to evaluate hypersensitivity to eight metal pollutants (antimony, manganese, mercury, molybdenum, nickel, platinum, tin, and titanium) selected by results of questionnaires on environmental burden, and by material analysis of generators and electrode surfaces. Exposures to metal pollutants were approximately the same in patients and in controls. Titanium alloy used in generators contained at least 99.32% of titanium and trace levels of other metals; higher levels of tin and platinum were detected in electrode surfaces. Hypersensitivity reactions to mercury and tin were significantly more frequent in patients than in controls (patients and controls: mercury: 68.2 and 31.1%, respectively; P = 0.022; tin: 25.0 and 3.2%, respectively; P = 0.035). In contrast, hypersensitivity to manganese was significantly more frequent in controls than in patients (patients and controls: 13.6 and 50.0%, respectively; P = 0.008). Conclusion Our findings suggest a possible relation between hypersensitivity to metals used in implantable devices or to environmental metal burden and the occurrence of their late complications.
ER  -

MAŇOUSEK, Jan, Irena ANDRŠOVÁ, Vera STEJSKAL, Jitka VLAŠÍNOVÁ, Milan SEPŠI, Jan KUTA, Jana KLÁNOVÁ, Michal MAZÍK, Jiří JARKOVSKÝ, Lenka ŠNAJDROVÁ, Klára BENEŠOVÁ, Tomáš NOVOTNÝ, Andrea ZADÁKOVÁ and Jindřich ŠPINAR. Hypersensitivity to material and environmental burden as a possible cause of late complications of cardiac implantable electronic devices. \textit{EP Europace}. Oxford: Oxford University Press, 2018, vol.~20, No~9, p.~''E140''-''E147'', 8 pp. ISSN~1099-5129. Available from: https://dx.doi.org/10.1093/europace/eux227.

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