101
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Hermida JS, Caus T, Traullé S, Kubala M. Partial extravenous course of cardiac pacemaker leads. A major risk during device-assisted extraction. HeartRhythm Case Rep 2015; 1:506-508. [PMID: 28491616 PMCID: PMC5419709 DOI: 10.1016/j.hrcr.2015.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
| | - Thierry Caus
- Cardiac Surgery Service, Amiens-Picardie University Hospital, Amiens, France
| | - Sarah Traullé
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
| | - Maciej Kubala
- Cardiac Arrhythmia Service, Amiens-Picardie University Hospital, Amiens, France
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102
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Kocabaş U, Duygu H, Eren NK, Akyıldız Zİ, Nazlı C. Percutaneous lead extraction by femoral approach, case report. INTERNATIONAL JOURNAL OF THE CARDIOVASCULAR ACADEMY 2015. [DOI: 10.1016/j.ijcac.2015.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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103
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Huang XM, Fu H, Osborn MJ, Asirvatham SJ, McLeod CJ, Glickson M, Acker NG, Friedman PA, Cha YM. Extraction of superfluous device leads: A comparison with removal of infected leads. Heart Rhythm 2015; 12:1177-82. [DOI: 10.1016/j.hrthm.2015.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Indexed: 10/24/2022]
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104
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Starck CT, Steffel J, Caliskan E, Holubec T, Schoenrath F, Maisano F, Falk V. Clinical performance of a new bidirectional rotational mechanical lead extraction sheath. Europace 2015; 18:253-6. [DOI: 10.1093/europace/euv126] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 04/01/2015] [Indexed: 11/14/2022] Open
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105
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Duque M, Díaz JC, Marín JE, Aristizábal JM, Velásquez JE, Duque L, Uribe W. Experiencia inicial con el retiro de electrodos de estimulación cardiaca mediante una técnica de extracción percutánea mecánica. REVISTA COLOMBIANA DE CARDIOLOGÍA 2015. [DOI: 10.1016/j.rccar.2015.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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106
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Segreti L, Di Cori A, Zucchelli G, Soldati E, Coluccia G, Viani S, Paperini L, Bongiorni MG. A Questionable Indication For ICD Extraction After Successful VT Ablation. J Atr Fibrillation 2015; 7:1172. [PMID: 27957158 DOI: 10.4022/jafib.1172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 12/26/2014] [Accepted: 01/02/2015] [Indexed: 11/10/2022]
Abstract
Sustained ventricular tachyarrhythmias represent a kind of complication shared by a number of clinical presentations of heart disease, sometimes leading to sudden cardiac death. Many efforts have been made in the fight against such a complication, mainly being represented by the implantable cardioverter defibrillator (ICD). In recent years, catheter ablation has grown as a means to effectively treat patients with sustained ventricular arrhythmias, in the contest of different cardiac substrates. Since carrying an ICD is associated with a potential risk deriving from its possible infective or malfunctioning complications, and given the current effectiveness of lead extraction procedures, it has been thought not to be unreasonable to ask ourselves about how to deal with ICD patients who have been successfully treated by means of ablation of their ventricular arrhythmias. To date, no control data have been published on transvenous lead extraction in the setting of VT ablation. In this paper we will review the current evidence about ICD therapy, catheter ablation of ventricular arrhythmias and lead extraction, trying to outline some considerations about how to face this new clinical issue.
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Affiliation(s)
- Luca Segreti
- Second Cardiology Division, Cardiothoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - Andrea Di Cori
- Second Cardiology Division, Cardiothoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - Giulio Zucchelli
- Second Cardiology Division, Cardiothoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - Ezio Soldati
- Second Cardiology Division, Cardiothoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - Giovanni Coluccia
- Second Cardiology Division, Cardiothoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - Stefano Viani
- Second Cardiology Division, Cardiothoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - Luca Paperini
- Second Cardiology Division, Cardiothoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - Maria Grazia Bongiorni
- Second Cardiology Division, Cardiothoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
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107
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Abstract
As a result of more cardiac implantable electronic devices being placed, a trend toward increasing device infections, and concerns regarding lead malfunction, there is an increased need for lead extraction skills and comprehensive lead management programs. This review discusses the current indications for lead extractions as well as the training requirements and tools and technology needed to create the foundation for a successful lead management program.
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Affiliation(s)
| | - Victor G Pretorius
- Division of Cardiothoracic Surgery, UCSD Health System, 9444 Medical Center Drive, La Jolla, San Diego, CA 92037, USA
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108
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Bongiorni MG, Di Cori A, Segreti L, Zucchelli G, Viani S, Paperini L, De Lucia R, Levorato D, Boem A, Soldati E. Transvenous extraction profile of Riata leads: Procedural outcomes and technical complexity of mechanical removal. Heart Rhythm 2015; 12:580-587. [DOI: 10.1016/j.hrthm.2014.12.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Indexed: 11/25/2022]
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109
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Zaca V, Marcucci R, Parodi G, Limbruno U, Notarstefano P, Pieragnoli P, Di Cori A, Bongiorni MG, Casolo G. Management of antithrombotic therapy in patients undergoing electrophysiological device surgery. Europace 2015; 17:840-54. [DOI: 10.1093/europace/euu357] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 11/13/2014] [Indexed: 11/14/2022] Open
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110
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Buiten MS, van der Heijden AC, Schalij MJ, van Erven L. How adequate are the current methods of lead extraction? A review of the efficiency and safety of transvenous lead extraction methods. Europace 2015; 17:689-700. [DOI: 10.1093/europace/euu378] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 12/02/2014] [Indexed: 12/30/2022] Open
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111
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Clinical utility of routine use of continuous transesophageal echocardiography monitoring during transvenous lead extraction procedure. Heart Rhythm 2015; 12:313-20. [DOI: 10.1016/j.hrthm.2014.10.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Indexed: 11/24/2022]
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112
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Aksu T, Özcan KS, Güler TE. A potential explanation for lower minor complication rate for lead extraction in high-volume centres. Europace 2015; 17:504. [PMID: 25614337 DOI: 10.1093/europace/euu343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Tolga Aksu
- Department of Cardiology, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Kazım Serhan Özcan
- Department of Cardiology, Derince Training and Research Hospital, Kocaeli, Turkey
| | - Tümer Erdem Güler
- Department of Cardiology, Derince Training and Research Hospital, Kocaeli, Turkey
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113
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MAYTIN MELANIE, DAILY THOMASP, CARILLO ROGERG. Virtual Reality Lead Extraction as a Method for Training New Physicians: A Pilot Study. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2014; 38:319-25. [DOI: 10.1111/pace.12546] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 09/14/2014] [Accepted: 09/28/2014] [Indexed: 11/30/2022]
Affiliation(s)
- MELANIE MAYTIN
- From the Brigham and Women's Hospital; Boston Massachusetts
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114
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Segreti L, Di Cori A, Soldati E, Zucchelli G, Viani S, Paperini L, De Lucia R, Coluccia G, Valsecchi S, Bongiorni MG. Major predictors of fibrous adherences in transvenous implantable cardioverter-defibrillator lead extraction. Heart Rhythm 2014; 11:2196-201. [DOI: 10.1016/j.hrthm.2014.08.011] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Indexed: 11/30/2022]
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115
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Intravascular recovery of electrode fragments as a possible complication of transvenous removal intervention. Int J Cardiol 2014; 177:560-3. [DOI: 10.1016/j.ijcard.2014.08.115] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 08/18/2014] [Indexed: 01/18/2023]
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116
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Ploux S, Jesel L, Eschalier R, Amraoui S, Ritter P, Haïssaguerre M, Bordachar P. Performance of a radiation protection cabin during extraction of cardiac devices. Can J Cardiol 2014; 30:1602-6. [PMID: 25418216 DOI: 10.1016/j.cjca.2014.08.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 08/11/2014] [Accepted: 08/12/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Operators who extract cardiac devices are exposed to considerable irradiation and excess risk of radiation-induced disorders. A dedicated radioprotection cabin was developed to offer complete protection against radiation. This randomized study was designed to ascertain the protection against radiation conferred by a radioprotection cabin and the safety during extraction of cardiac devices. METHODS Thirty-seven consecutive patients who presented with an indication for extraction of a cardiac device were randomly assigned to a standard extraction technique (n = 19), vs extraction with the use of a radiation protection cabin (n = 18). Fluoroscopic exposure was compared using electronic dosimeters placed on the thorax, back, foot, and head of the operator. RESULTS The procedural times and total fluoroscopic exposure times and the complication rates were not significantly different between the 2 groups. The mean dose of radiation delivered to the thorax and back was similar in both groups (P = 0.3 and P = 0.8, respectively). In contrast, the mean doses of radiation delivered to the head and to the feet were respectively 68 and 390 times less in the cabin group than in the control group (P < 0.001). CONCLUSIONS The cabin offers nearly full body radioprotection and eliminates the need to wear a lead apron, without increasing procedural time or complication rate during cardiac device extraction.
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Affiliation(s)
- Sylvain Ploux
- Hôpital Cardiologique Haut Leveque, University Bordeaux 2, LIRYC, L'Institut de rythmologie et modélisation cardiaque, Bordeaux-Pessac, France.
| | - Laurence Jesel
- Hôpital Cardiologique Haut Leveque, University Bordeaux 2, LIRYC, L'Institut de rythmologie et modélisation cardiaque, Bordeaux-Pessac, France
| | - Romain Eschalier
- Hôpital Cardiologique Haut Leveque, University Bordeaux 2, LIRYC, L'Institut de rythmologie et modélisation cardiaque, Bordeaux-Pessac, France; Clermont Université, ISIT-CaVITI, UMR6284, and CHU Clermont-Ferrand, Cardiology Department, Clermont-Ferrand, France
| | - Sana Amraoui
- Hôpital Cardiologique Haut Leveque, University Bordeaux 2, LIRYC, L'Institut de rythmologie et modélisation cardiaque, Bordeaux-Pessac, France
| | - Philippe Ritter
- Hôpital Cardiologique Haut Leveque, University Bordeaux 2, LIRYC, L'Institut de rythmologie et modélisation cardiaque, Bordeaux-Pessac, France
| | - Michel Haïssaguerre
- Hôpital Cardiologique Haut Leveque, University Bordeaux 2, LIRYC, L'Institut de rythmologie et modélisation cardiaque, Bordeaux-Pessac, France
| | - Pierre Bordachar
- Hôpital Cardiologique Haut Leveque, University Bordeaux 2, LIRYC, L'Institut de rythmologie et modélisation cardiaque, Bordeaux-Pessac, France
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117
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Starck CT, Stepuk A, Holubec T, Steffel J, Stark JW, Falk V. Compression coil provides increased lead control in extraction procedures. Europace 2014; 17:499-503. [DOI: 10.1093/europace/euu272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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118
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Removal of an intracardiac lost port-A catheter utilizing a simple low-cost method. Int J Cardiol 2014; 176:1309-11. [DOI: 10.1016/j.ijcard.2014.07.156] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 07/27/2014] [Indexed: 01/22/2023]
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119
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Superior vena cava obstruction as late complication of biventricular pacemaker implantation: Surgical replacement of the malfunctioning previous leads. Int J Cardiol 2014; 176:e83-5. [DOI: 10.1016/j.ijcard.2014.07.164] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 07/26/2014] [Indexed: 11/20/2022]
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120
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Asmarats L, Maristany J, Pons J, Buendía S, Gómez-Jaume A, Saus C, Macaya F, Pascual M, Bethencourt A, Van Malderen S, Szili-Torok T, Lever N, Webster M. How should I treat a patient with an entrapped infected permanent pacemaker lead? EUROINTERVENTION 2014; 10:403-5. [PMID: 25042269 DOI: 10.4244/eijv10i3a67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Luis Asmarats
- Department of Cardiology, Son Espases Hospital, Palma de Mallorca, Spain
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121
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Calvagna GM, Patanè S. Transvenous pacemaker lead extraction in infective endocarditis. Int J Cardiol 2014; 176:511-3. [PMID: 25085380 DOI: 10.1016/j.ijcard.2014.07.049] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 07/05/2014] [Indexed: 01/17/2023]
Affiliation(s)
- Giuseppe Mario Calvagna
- Cardiologia Ospedale San Vincenzo - Taormina (Me) Azienda Sanitaria Provinciale di Messina, 98039 Taormina (Messina), Italy.
| | - Salvatore Patanè
- Cardiologia Ospedale San Vincenzo - Taormina (Me) Azienda Sanitaria Provinciale di Messina, 98039 Taormina (Messina), Italy
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122
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Di Monaco A, Pelargonio G, Narducci ML, Manzoli L, Boccia S, Flacco ME, Capasso L, Barone L, Perna F, Bencardino G, Rio T, Leo M, Di Biase L, Santangeli P, Natale A, Rebuzzi AG, Crea F. Safety of transvenous lead extraction according to centre volume: a systematic review and meta-analysis. Europace 2014; 16:1496-507. [PMID: 24965015 DOI: 10.1093/europace/euu137] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Transvenous lead extraction (TLE) is a complex invasive procedure and the experience of the operator and the team is a major determinant of procedural outcomes. AIM Because of very limited data available on minimum procedural volumes to enable training and ongoing competency for TLEs, we performed a meta-analysis aimed at assessing the outcomes of TLE in the centres with low, medium, and high volume of procedures. METHODS Of the 280 papers initially retrieved until February 2013, 66 observational studies met inclusion criteria and were included in at least one stratified meta-analysis: 17 were prospective studies; 47 had a retrospective design; and 2 were defined 'experience studies'. We included only articles published after the introduction of laser technique (year 1999). We divided the studies in low, medium, and high volume centres utilizing either the European Heart Rhythm Association (EHRA) or Lexicon classification criteria. RESULTS When meta-analyses were carried out separately for the studies with larger and smaller sample sizes, either using EHRA or Lexicon classification criteria, no clear differences emerged in the combined rate of major complications or intraoperative deaths. In contrast, both minor complications and mortality at 30 days decreased as centre volume increased. CONCLUSIONS In our meta-analysis of observational studies, patients who have been treated in higher volume centres have a lower probability of minor complications and death at 30 days regardless of the infection rate, length of lead duration, type of device, and type of extraction.
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Affiliation(s)
- Antonio Di Monaco
- Department of Cardiovascular Sciences, Cardiology Institute, Catholic University of Sacred Heart, Rome, Italy
| | - Gemma Pelargonio
- Department of Cardiovascular Sciences, Cardiology Institute, Catholic University of Sacred Heart, Rome, Italy
| | - Maria Lucia Narducci
- Department of Cardiovascular Sciences, Cardiology Institute, Catholic University of Sacred Heart, Rome, Italy
| | - Lamberto Manzoli
- Department of Medicine and Aging Sciences, University 'G D'Annunzio' Chieti, Chieti, Italy
| | - Stefania Boccia
- Institute of Hygiene, Catholic University of Sacred Heart, Rome, Italy
| | - Maria Elena Flacco
- Department of Medicine and Aging Sciences, University 'G D'Annunzio' Chieti, Chieti, Italy
| | - Lorenzo Capasso
- Department of Medicine and Aging Sciences, University 'G D'Annunzio' Chieti, Chieti, Italy
| | - Lucy Barone
- Department of Cardiovascular Sciences, Cardiology Institute, Catholic University of Sacred Heart, Rome, Italy
| | - Francesco Perna
- Department of Cardiovascular Sciences, Cardiology Institute, Catholic University of Sacred Heart, Rome, Italy
| | - Gianluigi Bencardino
- Department of Cardiovascular Sciences, Cardiology Institute, Catholic University of Sacred Heart, Rome, Italy
| | - Teresa Rio
- Department of Cardiovascular Sciences, Cardiology Institute, Catholic University of Sacred Heart, Rome, Italy
| | - Milena Leo
- Department of Cardiovascular Sciences, Cardiology Institute, Catholic University of Sacred Heart, Rome, Italy
| | - Luigi Di Biase
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA Department of Cardiology, University of Foggia, Foggia, Italy
| | - Pasquale Santangeli
- Department of Cardiology, University of Foggia, Foggia, Italy Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Andrea Natale
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA
| | - Antonio Giuseppe Rebuzzi
- Department of Cardiovascular Sciences, Cardiology Institute, Catholic University of Sacred Heart, Rome, Italy
| | - Filippo Crea
- Department of Cardiovascular Sciences, Cardiology Institute, Catholic University of Sacred Heart, Rome, Italy
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123
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Forces applied during transvenous implantable cardioverter defibrillator lead removal. BIOMED RESEARCH INTERNATIONAL 2014; 2014:183483. [PMID: 24967337 PMCID: PMC4055293 DOI: 10.1155/2014/183483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 04/09/2014] [Accepted: 04/29/2014] [Indexed: 12/04/2022]
Abstract
Methods. 17 physicians, experienced in transvenous lead removal, performed a lead extraction manoeuvre of an ICD lead on a torso phantom. They were advised to stop traction only when further traction would be considered as harmful to the patient or when—based on their experience—a change in the extraction strategy was indicated. Traction forces were recorded with a digital precision gauge. Results. Median traction forces on the endocardium were 10.9 N (range from 3.0 N to 24.7 N and interquartile range from 7.9 to 15.3). Forces applied to the proximal end were estimated to be 10% higher than those measured at the tip of the lead due to a friction loss. Conclusion. A traction force of around 11 N is typically exerted during standard transvenous extraction of ICD leads. A traction threshold for a safe procedure derived from a pool of experienced extractionists may be helpful for the development of required adequate simulator trainings.
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124
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Chudzik M, Kutarski A, Mitkowski P, Przybylski A, Lewek J, Małecka B, Smukowski T, Maciąg A, Smigielski J. Endocardial Lead Extraction in the Polish Registry - clinical practice versus current Heart Rhythm Society consensus. Arch Med Sci 2014; 10:258-65. [PMID: 24904658 PMCID: PMC4042036 DOI: 10.5114/aoms.2013.33434] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2011] [Revised: 07/24/2011] [Accepted: 09/06/2011] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Over the last 10 years, there has been an increasing number of patients with pacemaker (PM) and cardioverter-defibrillator (ICD). This study is a retrospective analysis of indications for endocardial pacemaker and ICD lead extractions between 2003 and 2009 based on the experience of three Polish Referral Lead Extraction Centers. MATERIAL AND METHODS Since 2003, the authors have consecutively retrospectively collected all cases and entered the information in the database. All patients which had indication for lead extraction according to Heart Rhythm Society Guidelines were included to final analyze. Between 2003 and 2005, the data were analyzed together. Since 2006, data have been collected and analyzed annually. RESULTS In each year, a significant increase in lead extraction was observed. The main indications for LE were infections in 52.4% of patients. Nonfunctioning lead extraction constituted the second group of indications for LE in 29.7% of patients. During the registry period, the percentage of class I indications decreased from 80% in 2006 to only 47% in 2009. On the other hand, increasingly more leads were removed because of class 2, especially class 2b. In 2009, 40% of leads were extracted due to class 2b. CONCLUSIONS Polish Registry of Endocardial Lead Extraction 2003-2009, shows an increasing frequency of lead extraction. The main indication for LE is infection: systemic and pocket. An increase in class 2, especially 2b, LE indication in every center during the study period was found.
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Affiliation(s)
- Michał Chudzik
- Department of Electrocardiology, Medical University of Lodz, Poland
| | | | | | | | - Joanna Lewek
- Department of Cardiology, Medical University of Lodz, Poland
| | - Barbara Małecka
- Department of Electrocardiology, John Paul II Hospital, Krakow, Poland
| | - Tomasz Smukowski
- Department of Cardiology, Poznan University of Medical Sciences, Poland
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125
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Calvagna GM, Patanè S, Romeo P, Ceresa F, Sansone F, Patanè F. Embolization and retrieval of an anchoring sleeve during transvenous lead extraction. Int J Cardiol 2014; 173:e42-4. [DOI: 10.1016/j.ijcard.2014.03.114] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 03/14/2014] [Indexed: 01/24/2023]
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126
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Scarano M, Pezzuoli F, Torrisi G, Calvagna G, Patanè S. Cardiovascular implantable electronic device infective endocarditis. Int J Cardiol 2014; 173:e38-9. [DOI: 10.1016/j.ijcard.2014.03.075] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 03/12/2014] [Indexed: 11/16/2022]
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127
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Bongiorni MG, Segreti L, Di Cori A, Zucchelli G, Viani S, Paperini L, De Lucia R, Boem A, Levorato D, Soldati E. Safety and efficacy of internal transjugular approach for transvenous extraction of implantable cardioverter defibrillator leads. Europace 2014; 16:1356-62. [DOI: 10.1093/europace/euu004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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128
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Severe staphylococcal sepsis in patient with permanent pacemaker. Int J Cardiol 2014; 172:e498-501. [DOI: 10.1016/j.ijcard.2014.01.048] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 01/10/2014] [Indexed: 11/19/2022]
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129
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Diemberger I, Mazzotti A, Giulia MB, Biffi M, Cristian M, Massaro G, Matteo M, Martignani C, Letizia ZM, Ziacchi M, Reggiani B, Reggiani ML, Battistini P, Boriani G. From lead management to implanted patient management: systematic review and meta-analysis of the last 15 years of experience in lead extraction. Expert Rev Med Devices 2014; 10:551-73. [PMID: 23895081 DOI: 10.1586/17434440.2013.811837] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Percutaneous lead extraction is considered a safe and effective procedure, although published results derive primarily from cohort studies. The authors performed a systematic review and meta-analysis of the last 15 years' experience in this field, to give an objective evaluation of the efficacy and safety of this procedure. Moreover, the subsequent metaregression analysis enabled the identification of the main factors influencing these results: patient age, presence of leads in situ for more than 1 year, presence of device infection and use of laser sheath. These findings are significant in order to improve our extraction approach, data reporting and future research.
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Affiliation(s)
- Igor Diemberger
- Institute of Cardiology, Department of Experimental Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
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130
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KONERU JAYANTHIN, ELLENBOGEN KENNETHA. High-Risk Lead Extraction Using a Hybrid Approach: The Blade and the Lightsaber. J Cardiovasc Electrophysiol 2014; 25:622-3. [DOI: 10.1111/jce.12380] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- JAYANTHI N. KONERU
- Division of Cardiology; Department of Medicine; Medical College of Virginia/VCU School of Medicine; Richmond Virginia USA
| | - KENNETH A. ELLENBOGEN
- Division of Cardiology; Department of Medicine; Medical College of Virginia/VCU School of Medicine; Richmond Virginia USA
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131
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Regaining venous access for implantation of a new lead. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2014; 9:16-21. [PMID: 24570688 PMCID: PMC3915956 DOI: 10.5114/pwki.2013.34025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 12/22/2012] [Accepted: 01/14/2013] [Indexed: 12/01/2022] Open
Abstract
Introduction Venous occlusion is a relatively common complication of endocardial lead implantation. It may cause a critical problem when implantation of a new lead is needed. Traditional methods result in leaving abandoned leads. The optimal approach seems to be the extraction of the damaged or abandoned lead, regaining venous access and implantation of a new lead. Aim To assess the efficacy and safety of new lead implantation by the method of lead extraction. Material and methods All transvenous lead extraction procedures (203 patients) between 1 August 2008 and 15 October 2012 were assessed. The analysis included cases with leads implanted for at least 6 months prior to extraction. Results Regaining venous access was the main indication for lead extraction in 5 patients (4.9%). The reason for new lead implantation was lead damage (n = 7) and system up-grade to cardiac resynchronization therapy (CRT) (n = 3). In total, 23 leads were extracted (9 defibrillation leads, 12 pacing leads and 2 left ventricular leads). The mean time from the implantation was 92.2 ±43.2 (48-152) months. In all cases Cook mechanical sheaths were applied. The use of the Evolution system was necessary to extract 3 leads. In all cases the new leads were successfully implanted as planned. No serious complications occurred. Conclusions Diagnosis of venous occlusion should not be a contraindication for ipsilateral implantation of the new lead, because the techniques of transvenous lead extraction enable successful regaining of venous access.
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132
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Deckx S, Marynissen T, Rega F, Ector J, Nuyens D, Heidbuchel H, Willems R. Predictors of 30-day and 1-year mortality after transvenous lead extraction: a single-centre experience. Europace 2014; 16:1218-25. [DOI: 10.1093/europace/eut410] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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133
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Gomes S, Cranney G, Bennett M, Li A, Giles R. Twenty-year experience of transvenous lead extraction at a single centre. Europace 2014; 16:1350-5. [DOI: 10.1093/europace/eut424] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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134
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Bogale N, Witte K, Priori S, Cleland J, Auricchio A, Gadler F, Gitt A, Limbourg T, Linde C, Dickstein K. The European Cardiac Resynchronization Therapy Survey: comparison of outcomes between de novo cardiac resynchronization therapy implantations and upgrades. Eur J Heart Fail 2014; 13:974-83. [PMID: 21771823 DOI: 10.1093/eurjhf/hfr085] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Nigussie Bogale
- Stavanger University Hospital; Stavanger and Institute of Medicine, University of Bergen; Bergen Norway
| | - Klaus Witte
- Division of Cardiovascular Medicine and Diabetes; University of Leeds; Leeds LS2 9JT UK
| | | | - John Cleland
- Castle Hill Hospital, Hull York Medical School, University of Hull; Kingston-upon-Hull UK
| | - Angelo Auricchio
- Division of Cardiology; Fondazione Cardiocentro Ticino; Lugano Switzerland
| | | | - Anselm Gitt
- Institut für Herzinfarktforschung Ludwigshafen an der Universität Heidelberg; Ludwigshafen Germany
| | - Tobias Limbourg
- Institut für Herzinfarktforschung Ludwigshafen an der Universität Heidelberg; Ludwigshafen Germany
| | | | - Kenneth Dickstein
- Stavanger University Hospital; Stavanger and Institute of Medicine, University of Bergen; Bergen Norway
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135
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Starck CT, Caliskan E, Klein H, Steffel J, Falk V. Impact of a femoral snare approach as a bailout procedure on success rates in lead extractions. Interact Cardiovasc Thorac Surg 2014; 18:551-5. [DOI: 10.1093/icvts/ivu005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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136
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Madhavan M, Swale MJ, Gard JJ, Hayes DL, Asirvatham SJ. Contemporary pacemaker and ICD lead management: techniques for lead extraction. Expert Rev Cardiovasc Ther 2014; 10:875-87. [DOI: 10.1586/erc.12.75] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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137
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Diemberger I, Biffi M, Martignani C, Boriani G. From lead management to implanted patient management: indications to lead extraction in pacemaker and cardioverter–defibrillator systems. Expert Rev Med Devices 2014; 8:235-55. [PMID: 21381913 DOI: 10.1586/erd.10.80] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Igor Diemberger
- Institute of Cardiology, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
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138
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Zucchelli G, Coluccia G, Bongiorni MG. How to temporarily pace a pacemaker-dependent patient after lead extraction for device infection? Europace 2013; 16:1697. [DOI: 10.1093/europace/eut334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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139
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Short-term extraction profile of cardiac pacing leads with hybrid silicone–polyurethane insulator: A pilot study. Int J Cardiol 2013; 168:4432-3. [DOI: 10.1016/j.ijcard.2013.06.157] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Accepted: 06/30/2013] [Indexed: 11/22/2022]
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140
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Okamura H, Yasuda S, Sato S, Ogawa K, Nakajima I, Noda T, Shimahara Y, Hayashi T, Onishi Y, Kobayashi J, Kamakura S, Ogawa H, Shimizu W. Initial experience using Excimer laser for the extraction of chronically implanted pacemaker and implantable cardioverter defibrillator leads in Japanese patients. J Cardiol 2013; 62:195-200. [DOI: 10.1016/j.jjcc.2013.03.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 03/13/2013] [Accepted: 03/27/2013] [Indexed: 11/25/2022]
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141
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Durante-Mangoni E, Mattucci I, Agrusta F, Tripodi MF, Utili R. Current trends in the management of cardiac implantable electronic device (CIED) infections. Intern Emerg Med 2013; 8:465-76. [PMID: 22744804 DOI: 10.1007/s11739-012-0797-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 05/26/2012] [Indexed: 10/28/2022]
Abstract
Cardiac implantable electronic device (CIED) infections are an emerging clinical problem. A growing number of dedicated and high quality clinical studies are currently being generated. We here review the most recent advances in the diagnosis and treatment of patients with CIED infection including intracardiac lead endocarditis. We discuss the current etiology and risk factors, and appraise the major diagnostic issues, describing our center's therapeutic approach. We also address the management of CIED infection complications.
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Affiliation(s)
- Emanuele Durante-Mangoni
- Internal Medicine Section, Department of Cardiothoracic Sciences, University of Naples SUN, Naples, Italy
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142
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Zhou X, Jiang H, Ma J, Bakhai A, Li J, Zhang Y, Li Y, Wang D, Zhang Y, Xu G, Zhang J, Tang B. Comparison of standard and modified transvenous techniques for complex pacemaker lead extractions in the context of cardiac implantable electronic device-related infections: a 10-year experience. Europace 2013; 15:1629-35. [PMID: 23887094 DOI: 10.1093/europace/eut077] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS Complete lead extraction of cardiac implantable electronic devices (CIED) for device-related infections remains a complex procedure for chronically implantated leads. We present data from a single-centre registry of consecutive patients with extractions over 10 years. METHOD AND RESULTS Patients were identified from the centre's electronic database with CIED-related infections who underwent lead extraction using either the standard technique and equipment or a modified innovative transvenous lead technique extraction using an ablation catheter. Of 151 patients with CIED-related infections, not responding to simple manual traction to effect lead extraction, average age 65 ± 8 years (range 45-82), 64% being male, 75 underwent standard (S) extraction, and 76 underwent modified (M) extraction. Procedural, lead extraction, and fluoroscopy exposure times with S and M methods, respectively, were 65 ± 14 vs. 52 ± 6 min (P < 0.01), 56 ± 12 vs. 36 ± 8 min (P < 0.001), and 48 ± 12 vs. 31 ± 7 min (P < 0.001). Retrieval rates were numerically lower with the standard technique at 92 vs. 96% but did not achieve significance, with respective complication rates of 6.7 and 5.3%. CONCLUSION In our single-centre study, a modified extraction technique to retrieve leads for infections of CIEDs using a steerable ablation catheter has improved procedural parameters over the standard technique, without compromising clinical lead extraction success rates. This may be a promising approach for a future, prospective trial.
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Affiliation(s)
- XianHui Zhou
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, 137 Liyushan South Road, Urmuqi, Xinjiang 830011, China
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143
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Gierula J, Cubbon RM, Jamil HA, Byrom R, Baxter PD, Pavitt S, Gilthorpe MS, Hewison J, Kearney MT, Witte KKA. Cardiac resynchronization therapy in pacemaker-dependent patients with left ventricular dysfunction. Europace 2013; 15:1609-14. [PMID: 23736807 DOI: 10.1093/europace/eut148] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
AIMS Heart failure and left ventricular (LV) systolic dysfunction (LVSD) are common in patients with permanent pacemakers. The aim was to determine if cardiac resynchronization therapy (CRT) at the time of pulse generator replacement (PGR) is of benefit in patients with unavoidable RV pacing and LVSD. METHODS AND RESULTS Fifty patients with unavoidable RV pacing, LVSD, and mild or no symptoms of heart failure, listed for PGR were randomized 1 : 1 to either standard RV-PGR (comparator) or CRT. The primary endpoint was the difference in change in LV ejection fraction (LVEF) between RV-PGR and CRT groups from baseline to 6 months. Secondary endpoints included peak oxygen consumption, quality of life, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels. At 6 months there was a difference in change in median (interquartile range) LVEF [9 (6-12) vs. -1.5 (-4.5 to -0.8)%; P < 0.0001] between the CRT and RV-PGR arms. There were also improvements in exercise capacity (P = 0.007), quality of life (P = 0.03), and NT-proBNP (P = 0.007) in those randomized to CRT. After 809 (729-880) days, 17 patients had died or been hospitalized (6 in CRT group and 11 in the comparator RV-PGR group) and two patients in the RV-PGR arm had required CRT for deteriorating heart failure. Patients with standard RV-PGR had more days in hospital during follow-up than those in the CRT group [4 (2-7) vs. 11 (6-16) days; P = 0.047]. CONCLUSION Performing CRT in pacemaker patients with unavoidable RV pacing and LVSD but without severe symptoms of heart failure, at the time of PGR, improves cardiac function, exercise capacity, quality of life, and NT-pro-BNP levels.
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Affiliation(s)
- John Gierula
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health and Therapeutics, Multidisciplinary Cardiovascular Research Centre, University of Leeds, Clarendon Way, Leeds LS2 9JT, UK
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144
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CALVAGNA GIUSEPPEM, ROMEO PLACIDO, CERESA FABRIZIO, VALSECCHI SERGIO. Transvenous Retrieval of Foreign Objects Lost during Cardiac Device Implantation or Revision: A 10-Year Experience. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2013; 36:892-7. [DOI: 10.1111/pace.12148] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 02/18/2013] [Indexed: 11/30/2022]
Affiliation(s)
| | - PLACIDO ROMEO
- Division of Cardiology; San Vincenzo Hospital; Taormina; Messina; Italy
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145
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Mazzone P, Tsiachris D, Marzi A, Ciconte G, Paglino G, Sora N, Gulletta S, Vergara P, Della Bella P. Advanced techniques for chronic lead extraction: heading from the laser towards the evolution system. Europace 2013; 15:1771-6. [PMID: 23645529 DOI: 10.1093/europace/eut126] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Patrizio Mazzone
- Arrhythmia Unit and Electrophysiology Laboratories, Department of Cardiology and Cardiothoracic Surgery, Ospedale San Raffaele, via Olgettina 60, Milan, Italy
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146
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MAZZONE PATRIZIO, TSIACHRIS DIMITRIS, MARZI ALESSANDRA, CICONTE GIUSEPPE, PAGLINO GABRIELE, SORA NICOLETA, SALA SIMONE, VERGARA PASQUALE, GULLETTA SIMONE, BELLA PAOLODELLA. Predictors of Advanced Lead Extraction Based on a Systematic Stepwise Approach: Results from a High Volume Center. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2013; 36:837-44. [DOI: 10.1111/pace.12119] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 12/30/2012] [Accepted: 01/13/2013] [Indexed: 11/29/2022]
Affiliation(s)
- PATRIZIO MAZZONE
- Department of Cardiology and Cardiothoracic Surgery; Arrhythmia Unit and Electrophysiology Laboratories; Ospedale San Raffaele; Milan; Italy
| | - DIMITRIS TSIACHRIS
- Department of Cardiology and Cardiothoracic Surgery; Arrhythmia Unit and Electrophysiology Laboratories; Ospedale San Raffaele; Milan; Italy
| | - ALESSANDRA MARZI
- Department of Cardiology and Cardiothoracic Surgery; Arrhythmia Unit and Electrophysiology Laboratories; Ospedale San Raffaele; Milan; Italy
| | - GIUSEPPE CICONTE
- Department of Cardiology and Cardiothoracic Surgery; Arrhythmia Unit and Electrophysiology Laboratories; Ospedale San Raffaele; Milan; Italy
| | - GABRIELE PAGLINO
- Department of Cardiology and Cardiothoracic Surgery; Arrhythmia Unit and Electrophysiology Laboratories; Ospedale San Raffaele; Milan; Italy
| | - NICOLETA SORA
- Department of Cardiology and Cardiothoracic Surgery; Arrhythmia Unit and Electrophysiology Laboratories; Ospedale San Raffaele; Milan; Italy
| | - SIMONE SALA
- Department of Cardiology and Cardiothoracic Surgery; Arrhythmia Unit and Electrophysiology Laboratories; Ospedale San Raffaele; Milan; Italy
| | - PASQUALE VERGARA
- Department of Cardiology and Cardiothoracic Surgery; Arrhythmia Unit and Electrophysiology Laboratories; Ospedale San Raffaele; Milan; Italy
| | - SIMONE GULLETTA
- Department of Cardiology and Cardiothoracic Surgery; Arrhythmia Unit and Electrophysiology Laboratories; Ospedale San Raffaele; Milan; Italy
| | - PAOLO DELLA BELLA
- Department of Cardiology and Cardiothoracic Surgery; Arrhythmia Unit and Electrophysiology Laboratories; Ospedale San Raffaele; Milan; Italy
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147
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Palmisano P, Accogli M, Zaccaria M, Luzzi G, Nacci F, Anaclerio M, Favale S. Rate, causes, and impact on patient outcome of implantable device complications requiring surgical revision: large population survey from two centres in Italy. Europace 2013; 15:531-40. [PMID: 23407627 DOI: 10.1093/europace/eus337] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
AIMS The long-term impact of implantable device-related complications on the patient outcome has not been thoroughly evaluated. The aims of this retrospective, bi-centre study were to analyse the rate and nature of device-related complications requiring surgical revision in a large series of patients undergoing device implantation, elective generator replacement and pacing system upgrade and to systematically assess the impact of such complications on patient outcome and healthcare utilization. METHODS AND RESULTS Data from 2671 consecutive procedures (1511 device implantations, 1034 elective generator replacements, and 126 pacing system upgrades) performed between January 2006 and March 2011 were retrospectively analysed. The outcome measures recorded were complication-related mortality, number of re-operations, need for complex surgical procedures, number of re-hospitalizations, and additional hospital treatment days. Over a median follow-up of 27 months, the overall rate of complications was 2.8% per procedure-year [9.5% in cardiac resynchronisation therapy (CRT) device implantation, 6.1% in pacing system upgrade, 3.5% in implantable cardioverter defibrillator implantation, 1.7% in pacemaker implantation, and 1.7% in generator replacement). The procedure with the highest risk of complications was CRT device implantation (odds ratio: 6.6; P < 0.001); these complications primarily involved coronary sinus lead dislodgement and device infection. Patients with complications had a significantly higher number of device-related hospitalizations (2.3 ± 0.6 vs. 1.0 ± 0.1; P < 0.001) and hospital treatment days (15.7 ± 25.1 vs. 3.6 ± 1.1; P < 0.001) than those without complications. Device infection was the complication with the greatest negative impact on patient outcome. CONCLUSION Cardiac resynchronisation therapy implantation was the procedure with the highest risk of complications requiring surgical revision. Complications were associated with substantial clinical consequences and a significant increase in the number and length of hospitalizations.
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Affiliation(s)
- Pietro Palmisano
- Cardiology Unit, 'Card. G. Panico' Hospital, Tricase (Le), Italy.
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148
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Bracke FA, Dekker L, van Gelder BM. The Needle's Eye Snare as a primary tool for pacing lead extraction. ACTA ACUST UNITED AC 2012; 15:1007-12. [PMID: 23277531 DOI: 10.1093/europace/eus426] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Frank A Bracke
- Department of Cardiology, Catharina Hospital, Michelangelolaan 2, Eindhoven, The Netherlands.
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149
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Tascini C, Bongiorni MG, Di Cori A, Di Paolo A, Polidori M, Tagliaferri E, Fondelli S, Soldati E, Ciullo I, Leonildi A, Danesi R, Coluccia G, Menichetti F. Cardiovascular implantable electronic device endocarditis treated with daptomycin with or without transvenous removal. Heart Lung 2012; 41:e24-30. [PMID: 22436967 DOI: 10.1016/j.hrtlng.2012.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Revised: 02/04/2012] [Accepted: 02/06/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND METHODS Nine patients with cardiovascular implantable electronic device (CIED) endocarditis were treated with daptomycin after the failure of previous treatment. The blood and CIED lead cultures of 1 patient were negative. In the other 8 patients, we observed 6 monomicrobic infections and 2 polymicrobic infections. Overall, 10 strains were isolated in these patients: 4 methicillin-sensitive Staphylococcus aureus, 2 methicillin-sensitive Staphylococcus epidermidis, 1 methicillin-resistant Staphylococcus aureus, 1 methicillin-resistant Staphylococcus epidermidis, 1 methicillin-sensitive Staphylococcus hominis, and 1 Propionibacterium acnes. The CIED was removed transvenously in 7 patients. Two patients were too sick for the removal of their CIED, and were cured with 6 mg/kg of daptomycin for 60 and 110 days, respectively, without adverse events. RESULTS One patient died 4 days after the removal of his CIED because of a complicated abdominal aortic aneurysm. The other 8 patients were cured, with a mean follow-up of 17 ± 8 months. The removed leads were negative, after daptomycin therapy, in 4 cases out of 7. The mean ratio between peak daptomycin concentration and minimal inhibitory concentration (MIC) of the causative strains was 38.3 ± 18.5. For patients whose data were available, the ratio between peak daptomycin concentration and minimal bactericidal concentration (MBC) was 13.2 ± 3.2. CONCLUSION Daptomycin monotherapy may be a useful therapeutic tool in difficult-to-treat CIED endocarditis, resulting in a high rate of cures and sterilized leads removed. The ratio between peak daptomycin concentration and MIC or MBC may be useful as predictive tool for treatment success.
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Affiliation(s)
- Carlo Tascini
- Unità Operativa Malattie Infettive, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy
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150
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Yuasa T, Tanaka T, Suzuki N, Hirai T, Ui Y, Baba Y. A new tool for transvenous pacing lead extraction. J Arrhythm 2012. [DOI: 10.1016/j.joa.2012.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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