Technique for the surgical extraction of permanent pacing leads and electrodes

Byrd, Charles L.; Schwartz, Sanford; Sivina, Manuel; Yahr, William Z.; Greenberg, Jack J.

doi:10.1016/s0022-5223(19)38860-9

Cited by 46 publications

(15 citation statements)

References 14 publications

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“…In the present study, we observed a complication rate comparable with previously published data. [1][2][3][4][5]13,14 The presence of the pericardial drain inserted as part of the epicardial pacemaker implantation has been a helpful safety feature; bleeding into the drain allows early diagnosis of pericardial myocardial damage to be made. Therefore, surgical repair can be performed promptly and cardiac tamponade is prevented, allowing emergency repair to be done in good hemodynamic conditions.…”

Section: Discussionmentioning

confidence: 99%

Single surgical procedure combining epicardial pacemaker implantation and subsequent extraction of the infected pacing system for pacemaker-dependent patients

Amraoui¹,

Barandon²,

Whinnett³

et al. 2013

The Journal of Thoracic and Cardiovascular Surgery

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Section: Discussionmentioning

confidence: 99%

Single surgical procedure combining epicardial pacemaker implantation and subsequent extraction of the infected pacing system for pacemaker-dependent patients

Amraoui¹,

Barandon²,

Whinnett³

et al. 2013

The Journal of Thoracic and Cardiovascular Surgery

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“…However, in those patients with partial occlusion the rationale is not clear. The questions are whether it is prudent: (1) to cannulate a remaining patent side; and (2) to place leads through a partially occluded SVC, especially in young patients. Leads positioned in these veins have the potential for occluding the remaining patent side or completely occluding a partially occluded vein.…”

Section: Discussionmentioning

confidence: 99%

Transatrial Implantation of Transvenous Pacing Leads is an Alternative to Implantation of Epicardial Leads

Byrd¹,

Schwartz²

1990

Pacing Clinical Electrophis

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State-of-the-art pacing modalities are not readily utilized with conventional epicardial pacing lead implantation techniques. A transatrial implantation technique was developed combining a limited surgical approach with transvenous leads. Six patients who were poor candidates for transvenous implants have received DDD or DDDR pacemakers by this approach. The limited surgical approach includes resection of the third or fourth costal cartilage through a small skin incision, reflection of the pleura, and opening of the pericardium. The introducer and transvenous leads are inserted through a right atrial pursestring suture. The leads are positioned in the right ventricle and right atrium using standard fluoroscopic techniques. Through the incision, the subcutaneous tissue pocket is constructed on the right anterior chest wall. The leads are connected to the pacemaker without the need for adaptors or tunneling. There were no procedure-related complications. The magnitude of the surgery and postoperative morbidity are significantly less than for a standard thoracotomy, median sternotomy, and transdiaphragmatic epigastric or subcostal approach. The utility of the transatrial implantation technique is that it allows the use of state-of-the- art bipolar dual chamber pacemakers restoring access to all pacing modalities for those patients not candidates for transvenous implantation.

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“…To curtail morbidity, limited thoracotomy with a transatrial approach can be used: in this situation, lead(s) are grasped via the atriotomy and removed with direct traction or-in the case of dense fibrous encapsulating tissue around the lead-with the aid of a locking stylet and sheath while employing countertraction techniques. 16…”

Section: Cardiac Implantable Electronic Devicesmentioning

confidence: 99%

The Role of Collaboration Between Electrophysiologists and Surgeons in the Management of Complex Arrhythmia Patients

Gianni

Trivedi

Mohanty

2019

J Innov Cardiac Rhythm Manage.

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Technique for the surgical extraction of permanent pacing leads and electrodes

Cited by 46 publications

References 14 publications

Single surgical procedure combining epicardial pacemaker implantation and subsequent extraction of the infected pacing system for pacemaker-dependent patients

Single surgical procedure combining epicardial pacemaker implantation and subsequent extraction of the infected pacing system for pacemaker-dependent patients

Transatrial Implantation of Transvenous Pacing Leads is an Alternative to Implantation of Epicardial Leads

The Role of Collaboration Between Electrophysiologists and Surgeons in the Management of Complex Arrhythmia Patients

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