Use of the Mechanical Dilator Sheath for Removal of Endocardial Leads: A Single Center Experience

Aksu, Tolga; Güray, Ümit; Sen, Taner Z.; Durukan, Mine; Güray, Yeşım; Demirkan, Burcu; Kisacik, Halil

doi:10.1111/j.1540-8159.2012.03329.x

Cited by 10 publications

(7 citation statements)

References 14 publications

(30 reference statements)

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“…These findings suggest that excimer laser extraction can significantly reduce procedural duration and achieve substantially high extraction rates. Clinicians should, however, carefully consider the complications of the procedure, among which the incidence of death and fatal injury is reportedly up to 1% [3,4], and that of major complications, including superior vena cava laceration or massive pulmonary embolism, is about 1% [13,17,18].…”

Section: Discussionmentioning

confidence: 99%

Single-center experience with percutaneous lead extraction of cardiac implantable electric devices

Okada

Shoda

Tabata

et al. 2018

Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

Single-center experience with percutaneous lead extraction of cardiac implantable electric devices

Okada

Shoda

Tabata

et al. 2018

Journal of Cardiology

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“…In that study, complete lead removal rate was 94% in the laser group and 64% in the non-laser group, the major complication rates were similar (33). In a recent study, the success rate of mechanical dilator sheaths for lead extraction was 93% (34). Although those rates are encouraging, successful lead extraction requires a learning curve.…”

Section: Management Medical Treatmentmentioning

confidence: 86%

Management of cardiac device infections according to current data

Kafes¹,

Güray²,

İpek³

2013

Anadolu Kardiyol Derg

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The use of implantable devices in management of cardiac diseases is increasing as a result of improvements in technology of permanent pacemaker and implantable cardioverter defibrillators. Device related infections are also rising accordingly and have become an important clinical problem. Accurate diagnosis and optimal management of these infections is challenging, necessitating complete removal of the device and prolonged antibiotic therapy. In this regard, a multidisciplinary approach is required with the essential support of microbiology and imaging modalities. This paper highlights the current literature on the pathogenesis, risk factors, diagnosis and management of device related infections (Anadolu Kardiyol Derg 2014; 14: 76-81)

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“…In most patients, the leads can safely be removed under fluoroscopic guidance and close monitoring [15]. Although controversial, the emergent risk of a pericardial effusion and tamponade in these situations, as well the presence of surgical backup, can favor the decision for a prophylactic drain insertion.…”

Section: Discussionmentioning

confidence: 99%

Pacemaker Lead Perforation during Right Ventricular Outflow Tract Pacing -Importance of Heart Rotation at Pacemaker Implantation

Watanabe¹,

Shinoda²,

Ikeoka³

et al. 2016

J Clin Case Rep

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A 70 year-old woman underwent a dual-chamber pacemaker implantation for episodes of transient block and syncope. The transitional zone of her ECG was observed between V4 and V5, indicating clockwise rotation. An experienced physician performed the Right Ventricular Outflow Tract (RVOT) pacing using an active fixation lead without any immediate complications. For RVOT pacing, the lead was placed approximately two-thirds of the distance from the apex to the pulmonary valve in the postero-anterior view and pointing towards the septum in the left anterior oblique view. The ECG revealed a narrow QRS (120 msec) and the lead I morphology was minus-plus. Six days post-implant, a pacemaker interrogation revealed ventricular undersensing and loss of capture with high output pacing. Chest computed tomography revealed the left ventricle was displaced to the left and the left-sided angle between the interventricular septum and horizontal axis of the body was reduced to 16°. It confirmed an RV lead perforation through the RVOT, with 1 cm of the lead positioned outside the heart. We performed a surgical repair. Though ECG and x-rays showed septal pacing, we experienced an unusual case of a subacute myocardial perforation caused by an active fixation lead possibly due to heart rotation. The present case report described a patient with a subacute lead perforation and no hemodynamic instability. It is important for the general cardiologist to pay attention to heart rotation. After implantation, symptoms that can suggest a lead perforation, as major signs such as pericardial effusion are not necessarily present. A pacemaker interrogation shows lower impedance, as well as undersensing or failure to capture the involved chamber in suspicious findings.

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Use of the Mechanical Dilator Sheath for Removal of Endocardial Leads: A Single Center Experience

Abstract: Damaged or infected leads can safely and relatively easily be extracted by using this new percutaneous extraction technique.

Cited by 10 publications

References 14 publications

Single-center experience with percutaneous lead extraction of cardiac implantable electric devices

Single-center experience with percutaneous lead extraction of cardiac implantable electric devices

Management of cardiac device infections according to current data

Pacemaker Lead Perforation during Right Ventricular Outflow Tract Pacing -Importance of Heart Rotation at Pacemaker Implantation

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