Predictors of Complications of Endovascular Chronic Lead Extractions from Pacemakers and Defibrillators: A Single‐Operator Experience

Agarwal, Sunil; Kamireddy, Swapna; Němec, Jan; Voigt, Andrew; Saba, Samir

doi:10.1111/j.1540-8167.2008.01283.x

Cited by 95 publications

(68 citation statements)

References 13 publications

(13 reference statements)

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“…In our center's experience, successful lead extraction was achieved in about one third of patients, using simple traction with a nonlocking stylet, an outcome similar to that reported in several large series on older adult patients with simple extraction success rates ranging from 16.4% to 31.2%. [1][2][3][4][5]7,12 Of the leads undergoing a complex extraction in our study, about three quarters required the use of an RF-powered sheath, which was successful in more than half, for a cumulative success rate of 94%. There are no reports on the use of RF-powered sheaths in pediatric or adult CHD patients.…”

Section: Discussionmentioning

confidence: 99%

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Lead Extraction in Pediatric and Congenital Heart Disease Patients

Cecchin

Atallah

Walsh

et al. 2010

Circ: Arrhythmia and Electrophysiology

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Background-Transvenous pacemaker and defibrillator implantation is an expanding practice in pediatric and congenital heart disease patients, and given the finite longevity of current lead designs, lead extraction is an eventuality for a significant subset of these patients. were found to be associated with a decreased likelihood of simple extraction. There were 4 major and 4 minor procedural complications involving 8 patients and no procedure-related deaths. On univariate analysis, lead age (OR, 1.28; 95% CI, 1.09 to 1.50; Pϭ0.002) was the only factor associated with procedural complications. Conclusions-The majority of leads implanted in pediatric and congenital heart disease patients can be extracted successfully; however, the procedure carries a risk of serious complications. Older lead age, ventricular leads, and polyurethane insulation were independent predictors of the decreased likelihood of an extraction by simple traction. (Circ Arrhythm Electrophysiol. 2010;3:437-444.)

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Section: Discussionmentioning

confidence: 99%

“…Several large series have investigated the different lead extraction techniques and their safety and efficacy in adult patients without CHD. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] However, data on lead extraction in pediatric and CHD patients remain limited. [15][16][17][18] …”

mentioning

confidence: 99%

Lead Extraction in Pediatric and Congenital Heart Disease Patients

Cecchin

Atallah

Walsh

et al. 2010

Circ: Arrhythmia and Electrophysiology

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“…However, most studies suggest that morbidity is higher. 5,6 Complications of lead extraction can be catastrophic, with fatal outcomes despite immediate surgical intervention. 7 Major complications include cardiac or vascular avulsion, pulmonary embolism, stroke, cardiac tamponade, and retained ICD lead fragments.…”

Section: Lead Extractionmentioning

confidence: 99%

Management of the Patient With Implantable Cardioverter-Defibrillator Lead Failure

Kalahasty

Ellenbogen

2011

Circulation

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A 52-year-old man was brought to the emergency department because of multiple implantable cardioverterdefibrillator (ICD) shocks. His existing dual-chamber pacemaker was upgraded from a biventricular ICD 4 years ago. The ECG in the emergency department showed sinus tachycardia with left bundle-branch block at a rate of 135 bpm. In the emergency department, the patient received 5 additional shocks without a change in rhythm. A donut magnet was placed over the ICD. Interrogation revealed evidence of a lead fracture, and tachycardia therapies were disabled. The high-voltage lead was a Medtronic Sprint Fidelis ICD lead. Admission to the hospital was recommended for definitive correction of his problem.

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“…Ein Mittelwert aus mehreren Studien erbringt eine Mortalität von 0,4%. Der prozentuale Anteil an schwerwiegenden Komplikationen wird in der Literatur mit 0,3-7%, im Mittel mit 1,8% angegeben [1,9,[10][11][12][13][14].…”

Section: Wie Hoch Ist Das Risiko?unclassified

“…al. eine grö-ssere Anzahl zu extrahierender Sonden, ICD-Sonden und präoperativ erhöhte Leukozytenzahlen [9].…”

Section: Wie Hoch Ist Das Risiko?unclassified

Sondenextraktionen eine anspruchsvolle Aufgabe

2011

Cardiovasc Med

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Lead extraction, a demanding task: Every year approximately 1 0 000-15 000 pacemakerand ICD-leads are extracted worldwide with numbers continuing to rise. The increasing need for lead extractions may be explained by the evolution of pacemakerand ICD-implants during the last decade as well as by the widened spectrum of extraction devices and techniques. Last but not least, in 2009 the indications for transvenous lead extractions were broadened by the Heart Rhythm Society. Lead extraction are not simple operations at all, but instead can be very challenging with a recognisable risk profile. When carried out by specialised centres lead extractions may be performed with high success rates (>95%), and low complication rates (<2%) and mortality (<0.5%).

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Predictors of Complications of Endovascular Chronic Lead Extractions from Pacemakers and Defibrillators: A Single‐Operator Experience

Cited by 95 publications

References 13 publications

Lead Extraction in Pediatric and Congenital Heart Disease Patients

Lead Extraction in Pediatric and Congenital Heart Disease Patients

Management of the Patient With Implantable Cardioverter-Defibrillator Lead Failure

Sondenextraktionen eine anspruchsvolle Aufgabe

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