Intracardiac Echocardiography During Transvenous Lead Extraction

Schaller, Robert D.; Sadek, Mouhannad M.

doi:10.1016/j.ccep.2021.03.005

Cited by 1 publication

(1 citation statement)

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“…The lead to be removed can be fused to the chordae tendinae or even to the head of the papillary muscle and damages to these structures may go unnoticed. According to recent report, monitoring of TLE by intracardiac echocardiography may even more precisely visualize the growth of he leads to the walls of the heart, including the tricuspid valve [35].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Risk Factors for Major Complications of 1500 Transvenous Lead Extraction Procedures with Especial Attention to Tricuspid Valve Damage

Tułecki

Polewczyk

Jacheć³

et al. 2021

IJERPH

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Background: Transvenous lead extraction (TLE) is a relatively safe procedure, but it may cause severe complications such as cardiac/vascular wall tear (CVWT) and tricuspid valve damage (TVD). Methods: The risk factors for CVWT and TVD were examined based on an analysis of data of 1500 extraction procedures performed in two high-volume centers. Results: The total number of major complications was 33 (2.2%) and included 22 (1.5%) CVWT and 12 (0.8%) TVD (with one case of combined complication). Patients with hemorrhagic complications were younger, more often women, less often presenting low left ventricular ejection fraction (LVEF) and those who received their first cardiac implantable electronic device (CIED) earlier than the control group. A typical patient with CVWT was a pacemaker carrier, having more leads (including abandoned leads and excessive loops) with long implant duration and a history of multiple CIED-related procedures. The risk factors for TVD were similar to those for CVWT, but the patients were older and received their CIED about nine years earlier. Any form of tissue scar and technical problems were much more common in the two groups of patients with major complications. Conclusions: The risk factors for CVWT and TVD are similar, and the most important ones are related to long lead dwell time and its consequences for the heart (various forms of fibrotic scarring). The occurrence of procedural complications does not affect long-term survival in patients undergoing lead extraction.

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Section: Discussionmentioning

confidence: 99%