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Calvagna GM, Valsecchi S. Simultaneous subcutaneous implantable cardioverter-defibrillator and leadless pacemaker implantation for patients at high risk of infection: a retrospective case series report. J Interv Card Electrophysiol 2023:10.1007/s10840-023-01684-9. [PMID: 37938506 DOI: 10.1007/s10840-023-01684-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/25/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND The subcutaneous implantable cardioverter defibrillator (S-ICD) and leadless pacemaker (LP) are alternative options for patients at high risk of infection requiring ICD and pacing therapy. In this analysis, we described the simultaneous implantation of S-ICD and LP in patients with high infectious risk. METHODS The study cohort comprised patients referred to our institution for ICD implantation due to high-risk factors of infection. RESULTS Between 2018 and 2022, 13 patients were referred, including 11 with infected ICD and 2 for first ICD implantation in the presence of high-risk factors. In cases of infected ICD, successful extraction was performed using a mechanical dilatation technique. Reimplantation was delayed until resolution of infection with antibiotic therapy. The devices were implanted during a single procedure, with S-ICD implantation following LP placement for verification of sensing adequacy through surface ECG screening. Suitable vectors for sensing during inhibited and ventricular pacing were identified in all patients. Defibrillation testing was effective, and no issues with double counting or undersensing were observed. The postoperative period was uneventful, and during a median follow-up of 35 months, no complications or infections were reported. The median ventricular pacing percentage was 5%, and a single inappropriate shock episode due to myopotential interference was reported and resolved by reprogramming the sensing vector. CONCLUSION Simultaneous implantation of S-ICD and LP is feasible and safe in patients at high risk of infection requiring both ICD and pacing therapy. This combined approach provides an effective solution for these patients.
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Akhtar Z, Kontogiannis C, Georgiopoulos G, Starck CT, Leung LWM, Lee SY, Lee BK, Seshasai SRK, Sohal M, Gallagher MM. Comparison of non-laser and laser transvenous lead extraction: a systematic review and meta-analysis. Europace 2023; 25:euad316. [PMID: 37882609 PMCID: PMC10638006 DOI: 10.1093/europace/euad316] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/07/2023] [Accepted: 09/24/2023] [Indexed: 10/27/2023] Open
Abstract
AIMS Transvenous lead extraction (TLE) is performed using non-laser and laser techniques with overall high efficacy and safety. Variation in outcomes between the two approaches does exist with limited comparative evidence in the literature. We sought to compare non-laser and laser TLE in a meta-analysis. METHODS AND RESULTS We searched Medline, Embase, Scopus, ClinicalTrials.gov, and CENTRAL databases for TLE studies published between 1991 and 2021. From the included 68 studies, safety and efficacy data were carefully evaluated and extracted. Aggregated cases of outcomes were used to calculate odds ratio (OR), and pooled rates were synthesized from eligible studies to compare non-laser and laser techniques. Subgroup comparison of rotational tool and laser extraction was also performed. Non-laser in comparison with laser had lower procedural mortality (pooled rate 0% vs. 0.1%, P < 0.01), major complications (pooled rate 0.7% vs. 1.7%, P < 0.01), and superior vena cava (SVC) injury (pooled rate 0% vs. 0.5%, P < 0.001), with higher complete success (pooled rate 96.5% vs. 93.8%, P < 0.01). Non-laser comparatively to laser was more likely to achieve clinical [OR 2.16 (1.77-2.63), P < 0.01] and complete [OR 1.87 (1.69-2.08), P < 0.01] success, with a lower procedural mortality risk [OR 1.6 (1.02-2.5), P < 0.05]. In the subgroup analysis, rotational tool compared with laser achieved greater complete success (pooled rate 97.4% vs. 95%, P < 0.01) with lower SVC injury (pooled rate 0% vs. 0.7%, P < 0.01). CONCLUSION Non-laser TLE is associated with a better safety and efficacy profile when compared with laser methods. There is a greater risk of SVC injury associated with laser sheath extraction.
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Affiliation(s)
- Zaki Akhtar
- Department of Cardiology, St George’s University Hospital, London, UK
| | | | - Georgios Georgiopoulos
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece
| | - Christoph T Starck
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany
| | - Lisa W M Leung
- Department of Cardiology, St George’s University Hospital, London, UK
| | - Sun Y Lee
- Department of Medicine, San Joaquin General Hospital, French Camp, CA, USA
| | - Byron K Lee
- Division of Cardiology, University of California, San Francisco, CA, USA
| | | | - Manav Sohal
- Department of Cardiology, St George’s University Hospital, London, UK
| | - Mark M Gallagher
- Department of Cardiology, St George’s University Hospital, London, UK
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Nubila BCLSD, Lacerda GDC, Rey HCV, Barbosa RM. Percutaneous Removal of Cardiac Leads in a Single Center in South America. Arq Bras Cardiol 2021; 116:908-916. [PMID: 34008813 PMCID: PMC8121483 DOI: 10.36660/abc.20190726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 02/29/2020] [Accepted: 04/08/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In the last decade, the number of cardiac electronic devices has risen considerably and consequently the occasional need for their removal. Concurrently, the transvenous lead removal became a safe procedure that could prevent open-heart surgery. OBJECTIVE The primary objective of this study was to describe the successful performance and the complication rates of pacemaker removals in a Brazilian public hospital. Our secondary aim was to describe the variables associated to successes and complications. METHODS A retrospective case series was conducted in patients submitted to pacemaker removal in a Brazilian public hospital from January 2013 to June 2018. Removal, explant, extraction, success and complication rates were defined by the 2017 Heart Rhythm Society Guideline. Categorical variables were compared using x2 or Fisher's tests, while continuous variables were compared by unpaired tests. A p-value of 0.05 was considered statistically significant. RESULTS Cardiac device removals were performed in 61 patients, of which 51 were submitted to lead extractions and 10 to lead explants. In total, 128 leads were removed. Our clinical success rate was 100% in the explant group and 90.2% in the extraction one (p=0.58). Major complications were observed in 6.6% patients. Procedure failure was associated to older right ventricle (p=0.05) and atrial leads (p=0,04). Procedure duration (p=0.003) and need for blood transfusion (p<0,001) were associated to more complications. CONCLUSION Complications and clinical success were observed in 11.5% and 91.8% of the population, respectively. Removal of older atrial and ventricular leads were associated with lower success rates. Longer procedures and blood transfusions were associated with complications.
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Affiliation(s)
- Bruna Costa Lemos Silva Di Nubila
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ - Brasil
- Hospital Pró-CardíacoRio de JaneiroRJBrasilHospital Pró-Cardíaco, Rio de Janeiro, RJ - Brasil
| | - Gustavo de Castro Lacerda
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ - Brasil
| | - Helena Cramer Veiga Rey
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ - Brasil
| | - Rodrigo Minati Barbosa
- Instituto Nacional de CardiologiaRio de JaneiroRJBrasilInstituto Nacional de Cardiologia, Rio de Janeiro, RJ - Brasil
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Michalak M, Januszkiewicz Ł, Majstrak F, Gawałko M, Opolski G, Grabowski M. Endovascular extraction of entrapped long-term central feeding catheter: Case series. J Vasc Access 2018; 20:329-332. [PMID: 30165799 DOI: 10.1177/1129729818792822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Long-term tunneled central venous catheters are widely used in several clinical indications, that is, hemodialysis, chemotherapy, and total parenteral nutrition. However, central venous catheters are associated with a number of complications, including catheter occlusion and sepsis, which may necessitate earlier catheter removal. In most cases manual traction is sufficient to remove the catheter. Nevertheless, in some cases severe adhesions, formed between the catheter and the vessel wall, complicate simple catheter removal. We present four cases of entrapped long-term central venous catheters and describe methods (e.g. endoluminal balloon dilatation and wire snare) performed by experienced cardiologists at high-volume center to remove them. We claim that permanent central venous catheters removal procedures may be unpredictable and hazardous. Therefore, entrapped central venous catheters should be extracted by experienced operators in specialized high-volume centers.
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Affiliation(s)
- Marcin Michalak
- 1 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | | | - Franciszek Majstrak
- 2 1st Department of Cardiac Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Monika Gawałko
- 1 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Grzegorz Opolski
- 1 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Grabowski
- 1 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
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Kutarski A, Czajkowski M, Pietura R, Obszański B, Polewczyk A, Jacheć W, Polewczyk M, Młynarczyk K, Grabowski M, Opolski G. Effectiveness, safety, and long-term outcomes of non-powered mechanical sheaths for transvenous lead extraction. Europace 2017; 20:1324-1333. [DOI: 10.1093/europace/eux218] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 06/06/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Andrzej Kutarski
- Department of Cardiology, Medical University of Lublin, 8 Jaczewskiego St., Lublin, Poland
| | - Marek Czajkowski
- Department of Cardiac Surgery Medical, University of Lublin, 8 Jaczewskiego St., Lublin, Poland
| | - Radosław Pietura
- Department of Radiography Medical, University of Lublin, 8 Jaczewskiego St., Lublin, Poland
| | - Bogdan Obszański
- Department of Cardiology, The Pope John Paul II Province Hospital of Zamosc, 10 Aleje Jana Pawła II St., Zamosc, Poland
| | - Anna Polewczyk
- 2nd Department of Cardiology, Swietokrzyskie Cardiology Center, 45 Grunwaldzka St., Kielce, Poland
- Department of Health Sciences, The Jan Kochanowski University, 5 Żeromskiego Str., Kielce, Poland
| | - Wojciech Jacheć
- 2nd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 12 Bankowa Str., Katowice, Poland
| | - Maciej Polewczyk
- Department of Cardiology, District Hospital, 45 Grunwaldzka Str., Kielce, Poland
| | - Krzysztof Młynarczyk
- Department of Cardiology, Specialistic Hospital, 13 Szpitalna Str., Tarnow, Poland
| | - Marcin Grabowski
- 1st Department of Cardiology, Medical University of Warsaw, Banacha 1a Street, Warsaw, Poland
| | - Grzegorz Opolski
- 1st Department of Cardiology, Medical University of Warsaw, Banacha 1a Street, Warsaw, Poland
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Azevedo AI, Primo J, Gonçalves H, Oliveira M, Adão L, Santos E, Ribeiro J, Fonseca M, Dias AV, Vouga L, Ribeiro VG. Lead Extraction of Cardiac Rhythm Devices: A Report of a Single-Center Experience. Front Cardiovasc Med 2017; 4:18. [PMID: 28451588 PMCID: PMC5390030 DOI: 10.3389/fcvm.2017.00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/16/2017] [Indexed: 11/13/2022] Open
Abstract
Introduction and objectives The rate of implanted cardiac electronic devices is increasing as is the need to manage long-term complications. Lead removal is becoming an effective approach to treat such complications. We present our experience in lead removal using different approaches, analyzing the predictors of the use of mechanical extractors/surgical removal. Methods Retrospective analysis of lead extractions in a series of 76 consecutive patients (mean age 70.4 ± 13.8 years, 73.7% men) between January 2009 and November 2015. Results One hundred thirty-five leads from permanent pacemakers (single chamber 19.7%; dual-chamber 61.8%), implantable cardioverter defibrillators (5.3%), and cardiac resynchronization devices (CRT-P 2.6%; CRT-D 7.9%) were removed, 72.5 ± 73.2 months after implantation. A total of 45.9% were ventricular leads, 40.0% atrial leads, 8.9% defibrillator leads, and 5.2% leads in the coronary sinus; 64.4% had passive fixation. The most common indications for removal were pocket infection (77.8%), infective endocarditis (9.6%), and lead dislodgement (3.7%). A total of 76.3% of the leads were explanted, 20.0% were extracted, and 3.7% were surgically removed. Extraction of the entire lead was achieved in 96.3% of the procedures. After logistic regression (age adjusted), time since implantation was the sole predictor of the need of mechanical extractors/surgical removal. All patients were discharged without major complications. There were no deaths at 30 days. Conclusion Our experience in lead removal was effective and safe. Performing these procedures by experienced electrophysiologists with an adequate cardiothoracic surgery team on standby to cope with any complications is required. Referral of high-risk patients to a high-volume center is recommended to optimize clinical success and minimize procedural complications.
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Affiliation(s)
- Ana Isabel Azevedo
- Cardiology, Vila Nova de Gaia/Espinho Hospital Centre, Vila Nova de Gaia, Portugal
| | - João Primo
- Cardiology, Vila Nova de Gaia/Espinho Hospital Centre, Vila Nova de Gaia, Portugal
| | - Helena Gonçalves
- Cardiology, Vila Nova de Gaia/Espinho Hospital Centre, Vila Nova de Gaia, Portugal
| | - Marco Oliveira
- Cardiology, Vila Nova de Gaia/Espinho Hospital Centre, Vila Nova de Gaia, Portugal
| | - Luís Adão
- Cardiology, Vila Nova de Gaia/Espinho Hospital Centre, Vila Nova de Gaia, Portugal
| | - Elisabeth Santos
- Cardiology, Vila Nova de Gaia/Espinho Hospital Centre, Vila Nova de Gaia, Portugal
| | - José Ribeiro
- Cardiology, Vila Nova de Gaia/Espinho Hospital Centre, Vila Nova de Gaia, Portugal
| | - Marlene Fonseca
- Cardiology, Vila Nova de Gaia/Espinho Hospital Centre, Vila Nova de Gaia, Portugal
| | - Adelaide V Dias
- Cardiology, Vila Nova de Gaia/Espinho Hospital Centre, Vila Nova de Gaia, Portugal
| | - Luís Vouga
- Cardiothoracic Surgery, Vila Nova de Gaia/Espinho Hospital Centre, Vila Nova de Gaia, Portugal
| | - Vasco Gama Ribeiro
- Cardiology, Vila Nova de Gaia/Espinho Hospital Centre, Vila Nova de Gaia, Portugal
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Manolis AS, Melita H. Managing infected cardiovascular implantable electronic devices. ACTA ACUST UNITED AC 2016. [DOI: 10.1002/cce2.38] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - H. Melita
- Onassis Cardiac Surgery Center; Athens Greece
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8
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Calvagna GM, Patanè S, Celona A, Inserra MC, Vasquez L, Romeo P. Transvenous recovery of a foreign body inside the lumen of the segmental branches of the right pulmonary artery tree. Int J Cardiol 2016; 214:229-32. [DOI: 10.1016/j.ijcard.2016.03.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 03/19/2016] [Indexed: 02/06/2023]
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9
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Calvagna GM, Vasquez L, Patanè F, Sansone F, Ceresa F, Tassone L, Patanè S. The safety and effectiveness of closure access leading venous advanced gain new ability. Int J Cardiol 2016; 207:39-43. [PMID: 26788821 DOI: 10.1016/j.ijcard.2016.01.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 01/02/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Giuseppe Mario Calvagna
- Cardiologia Ospedale San Vincenzo, Taormina (Me) Azienda Sanitaria Provinciale di Messina, 98039, Taormina, (Messina), Italy.
| | - Ludovico Vasquez
- Cardiologia Ospedale San Vincenzo, Taormina (Me) and Cardiologia Presidio Ospedaliero "G. Fogliani", Milazzo (ME) Azienda Sanitaria Provinciale di Messina, Italy
| | - Francesco Patanè
- Cardiochirurgia Ospedale Papardo Messina, Azienda Ospedaliera Ospedali Riuniti Papardo Piemonte, 98158 Messina, Italy
| | - Fabrizio Sansone
- Cardiochirurgia Ospedale Papardo Messina, Azienda Ospedaliera Ospedali Riuniti Papardo Piemonte, 98158 Messina, Italy
| | - Fabrizio Ceresa
- Cardiochirurgia Ospedale Papardo Messina, Azienda Ospedaliera Ospedali Riuniti Papardo Piemonte, 98158 Messina, Italy
| | - Laura Tassone
- Cardiochirurgia Ospedale Papardo Messina, Azienda Ospedaliera Ospedali Riuniti Papardo Piemonte, 98158 Messina, Italy
| | - Salvatore Patanè
- Cardiologia Ospedale San Vincenzo, Taormina (Me) Azienda Sanitaria Provinciale di Messina, 98039, Taormina, (Messina), Italy
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10
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Calvagna GM, Patanè S, Vasquez L. Closure access leading venous advanced gain new ability: A new technique to overcome implantable device venous occlusion. Int J Cardiol 2016; 202:911-3. [PMID: 26479957 DOI: 10.1016/j.ijcard.2015.10.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 10/04/2015] [Indexed: 11/15/2022]
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
| | - Ludovico Vasquez
- Cardiologia Ospedale San Vincenzo, Taormina (Me) and Cardiologia Presidio Ospedaliero "G. Fogliani", Milazzo (Me) Azienda Sanitaria Provinciale di Messina, Italy
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11
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Calvagna GM, Patanè S, Ceresa F, Fontana A, Sicuso G, Vinci E, Muscio G, Vasquez L, Patanè F. Inadvertent implantation of a pacemaker lead in the left ventricle: A new challenge in cardiology. Int J Cardiol 2016; 202:914-7. [PMID: 26479958 DOI: 10.1016/j.ijcard.2015.10.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 10/04/2015] [Indexed: 11/26/2022]
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
| | - Fabrizio Ceresa
- Cardiochirurgia Ospedale Papardo Messina, Azienda Ospedaliera Ospedali Riuniti Papardo Piemonte, 98158 Messina, Italy
| | - Alessandro Fontana
- Cardiologia Ospedale San Vincenzo - Taormina (Me) Azienda Sanitaria Provinciale di Messina, 98039, Taormina (Messina), Italy
| | | | - Eugenio Vinci
- UOC Cardiologia Ospedale Umberto I° ASP Siracusa, Italy
| | | | - Ludovico Vasquez
- Cardiologia Ospedale San Vincenzo - Taormina (Me) and Cardiologia Presidio Ospedaliero "G. Fogliani" - Milazzo (ME) Azienda Sanitaria Provinciale di Messina, Italy
| | - Francesco Patanè
- Cardiochirurgia Ospedale Papardo Messina, Azienda Ospedaliera Ospedali Riuniti Papardo Piemonte, 98158 Messina, Italy
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Abstract
BACKGROUND Percutaneous lead extraction represents one of the most difficult and challenging interventions in the therapy with cardiac implantable electronic devices (CIEDs). Despite the progress in outcome and safety of these procedures in the last decade, the first published results of the ELECTRa registry point out that the risk of life-threatening complications should not be underestimated. Therefore, pre-operative screening for indications, present infections, pacemaker dependency, age and type of implanted leads, previous cardiac surgery and presence of anatomic variations are prerequisite to assess the individual operation risk. RESULTS Apart from the decision for any particular operative approach, the risk-adjusted settings should be selected in order to enable intraoperative escalation of extraction methods, if needed. A good theoretical knowledge of potential perioperative problems and complications as well as the intraoperative use of TEE enables early detection and management of complications. Furthermore, preoperative arrangements with other professionals and a team approach in emergency management enable fast and structured action when needed, thus, reducing mortality in case of life-threatening complications.
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Affiliation(s)
- Heiko Burger
- Abteilung für Herzchirurgie, Kerckhoff-Klinik GmbH, Benekestraße 2-8, 61231, Bad Nauheim, Deutschland.
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13
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Calvagna GM, Ceresa F, Morgante A, Patanè S. Transvenous extraction of a left subclavian dialysis catheter: A new challenge in cardiology. Int J Cardiol 2015; 185:144-7. [PMID: 25795205 DOI: 10.1016/j.ijcard.2015.03.085] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 03/07/2015] [Indexed: 12/16/2022]
Affiliation(s)
- Giuseppe Mario Calvagna
- Cardiologia Ospedale San Vincenzo-Taormina (Me), Azienda Sanitaria Provinciale di Messina, 98039 Taormina, Messina, Italy.
| | - Fabrizio Ceresa
- Cardiochirurgia Ospedale Papardo Messina, Azienda Ospedaliera Ospedali Riuniti Papardo Piemonte, 98158 Messina, Italy
| | - Alessandro Morgante
- Cardiochirurgia Ospedale Papardo Messina, Azienda Ospedaliera Ospedali Riuniti Papardo Piemonte, 98158 Messina, Italy
| | - Salvatore Patanè
- Cardiologia Ospedale San Vincenzo-Taormina (Me), Azienda Sanitaria Provinciale di Messina, 98039 Taormina, Messina, Italy
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14
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Calvagna GM, Patanè S, Romeo P, Condorelli S, Vasquez L. Transvenous recovery of an intracardiac fractured port-A catheter fragment. Int J Cardiol 2015; 185:214-7. [PMID: 25797680 DOI: 10.1016/j.ijcard.2015.03.087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 03/07/2015] [Indexed: 11/18/2022]
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
| | - Placido Romeo
- Radiologia Ospedale San Vincenzo - Taormina (Me), Azienda Sanitaria Provinciale di Messina, 98039 Taormina, Messina, Italy
| | - Sonja Condorelli
- UOC Oncologia Presidio di Caltagirone, Azienda Sanitaria Provinciale di Catania, Italy
| | - Ludovico Vasquez
- Cardiologia Ospedale San Vincenzo - Taormina (Me), Azienda Sanitaria Provinciale di Messina, 98039 Taormina, Messina, Italy; Cardiologia Presidio Ospedaliero "G. Fogliani" - Milazzo (ME), Azienda Sanitaria Provinciale di Messina, Italy
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15
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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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17
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Calvagna GM, Patanè S. A complete bicameral pacemaker pocket decubitus. Int J Cardiol 2015; 181:340-3. [PMID: 25555273 DOI: 10.1016/j.ijcard.2014.12.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 12/21/2014] [Indexed: 12/01/2022]
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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18
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Calvagna GM, Patanè S. Transvenous pacemaker lead extraction by femoral approach. Int J Cardiol 2015; 180:145-8. [PMID: 25438236 DOI: 10.1016/j.ijcard.2014.11.128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 11/23/2014] [Indexed: 10/24/2022]
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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A subcutaneous finger cardioverter-defibrillator system removal under local anesthesia. Int J Cardiol 2015; 179:42-5. [PMID: 25464407 DOI: 10.1016/j.ijcard.2014.10.053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Accepted: 10/20/2014] [Indexed: 12/17/2022]
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Calvagna GM, Patanè S. Cardiac rehabilitation in pacing venous occlusions. Int J Cardiol 2015; 179:248-51. [PMID: 25464458 DOI: 10.1016/j.ijcard.2014.11.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 11/03/2014] [Indexed: 12/19/2022]
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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21
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Cardiac rehabilitation in pacing patient complications: an increasing scenario requiring a collaborative vision of a multi-disciplinary treatment team. Int J Cardiol 2015; 178:168-70. [DOI: 10.1016/j.ijcard.2014.10.145] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 10/22/2014] [Indexed: 02/06/2023]
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22
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Cardiac perforation of the right ventricle: A rare complication of pacemaker implantation. The importance of a collaborative vision of a multi-disciplinary treatment team. Int J Cardiol 2014; 177:621-4. [DOI: 10.1016/j.ijcard.2014.09.097] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 09/20/2014] [Indexed: 02/08/2023]
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23
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Calvagna GM, Ceresa F, Patanè S. Pocket infection as a complication of a subcutaneous implantable cardioverter-defibrillator. Int J Cardiol 2014; 177:616-8. [DOI: 10.1016/j.ijcard.2014.09.119] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 09/20/2014] [Indexed: 12/15/2022]
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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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25
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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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26
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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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27
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Calvagna GM, Ceresa F, Patanè S. Subcutaneous implantable cardioverter-defibrillator in a young woman. Int J Cardiol 2014; 175:e30-2. [DOI: 10.1016/j.ijcard.2014.04.119] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 04/09/2014] [Indexed: 11/26/2022]
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28
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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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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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Calvagna GM, Torrisi G, Giuffrida C, Patanè S. Pacemaker, implantable cardioverter defibrillator, CRT, CRT-D, psychological difficulties and quality of life. Int J Cardiol 2014; 174:378-80. [DOI: 10.1016/j.ijcard.2014.03.187] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 03/29/2014] [Indexed: 11/15/2022]
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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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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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33
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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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34
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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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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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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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WILLIAMS STEVENE, ARUJUNA ARUNA, WHITAKER JOHN, SOHAL MANAV, SHETTY ANOOPK, ROY DEBASHIS, BOSTOCK JULIAN, COOKLIN MICHAEL, GILL JASWINDER, O’NEILL MARK, WRIGHT MATTHEW, PATEL NIKHIL, BUCKNALL CLIFF, HAMID SHOAIB, RINALDI CALDO. Percutaneous Extraction of Cardiac Implantable Electronic Devices (CIEDs) in Octogenarians. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2012; 35:841-9. [DOI: 10.1111/j.1540-8159.2012.03400.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Complete removal as a routine treatment for any cardiovascular implantable electronic device-associated infection. J Thorac Cardiovasc Surg 2011; 142:1482-90. [PMID: 21570093 DOI: 10.1016/j.jtcvs.2010.11.059] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 10/17/2010] [Accepted: 11/02/2010] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Pacemaker and implantable cardioverter defibrillator lead endocarditis mandates removal of all foreign material. In supposedly limited (pocket) infections, such a radical approach is still controversial. Thus, some patients are potentially exposed to persistent and recurrent infection because of retained material. Procedural risks and the success of eradicating infection were examined if involvement of the complete system was assumed in any cardiovascular implantable electronic device infection and complete removal was thus mandatory. METHODS A 12-year experience with 192 consecutive cases of bacterial pacemaker (152) or defibrillator (40) infections is presented. Complete removal of all prosthetic material was always aimed for. This was followed by antibiotic treatment for 4 to 6 weeks under temporary pacing if required, and then the new system was implanted. A total of 104 parameters concerning patient characteristics and operative and postoperative treatment were examined for their influence on outcome. RESULTS Infection was eradicated in 92.8% of patients. Recurrence was predominantly caused by failure to remove all prosthetic material (P < .001). If the protocol was strictly followed, infection was eradicated in 97.4% of patients. Conversely, 71.4% of patients with retained material showed recurrence. Further risk factors were poor dental hygiene and evidence of chronic subclinical infection. Morbidity and mortality of the interventional and open procedures were low. Open lead extraction was performed primarily in 34 patients (17.7%) and secondarily in 3 patients (1.9%). Temporary pacing and long-term antibiotic treatment were well tolerated. CONCLUSIONS Complete removal of prosthetic material in any cardiovascular implantable electronic device infection is safe and associated with low morbidity and mortality. Success of eradicating infection is high if all system components are removed. Temporary pacing in dependent patients may be performed safely on an outpatient basis.
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WILLIAMS STEVENE, ARUJUNA ARUNA, WHITAKER JOHN, SHETTY ANOOPK, BOSTOCK JULIAN, PATEL NIKHIL, MOBB MARGARET, COOKLIN MIKE, GILL JASWINDER, BLAUTH CHRISTOPHER, BUCKNALL CLIFF, HAMID SHOAIB, RINALDI CALDO. Percutaneous Lead and System Extraction in Patients with Cardiac Resynchronization Therapy (CRT) Devices and Coronary Sinus Leads. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2011; 34:1209-16. [DOI: 10.1111/j.1540-8159.2011.03149.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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40
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CALVAGNA GIUSEPPEM, EVOLA ROSARIO, SCARDACE GIUSEPPE, VALSECCHI SERGIO. Successful Removal of a Jugular Implantable Defibrillator Lead with Mechanical Single-Sheath Technique. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2011; 35:e258-60. [DOI: 10.1111/j.1540-8159.2011.03109.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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41
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Infections of cardiac implantable electronic devices and their prevention. COR ET VASA 2010. [DOI: 10.33678/cor.2010.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kröpil P, Lanzman RS, Miese FR, Blondin D, Winter J, Scherer A, Fürst G. Minimally invasive catheter procedures to assist complicated pacemaker lead extraction and implantation in the operating room. Cardiovasc Intervent Radiol 2010; 34:345-51. [PMID: 20502898 DOI: 10.1007/s00270-010-9887-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Accepted: 04/08/2010] [Indexed: 01/04/2023]
Abstract
We report on percutaneous catheter procedures in the operating room (OR) to assist complicated manual extraction or insertion of pacemaker (PM) and implantable cardioverter defibrillator leads. We retrospectively reviewed complicated PM revisions and implantations performed between 2004 and 2009 that required percutaneous catheter procedures performed in the OR. The type of interventional procedure, catheter and retrieval system used, venous access, success rates, and procedural complications were analyzed. In 41 (12 female and 29 male [mean age 62 ± 17 years]) of 3021 (1.4%) patients, standard manual retrieval of old leads or insertion of new leads was not achievable and thus required percutaneous catheter intervention for retrieval of misplaced leads and/or recanalisation of occluded central veins. Thirteen of 18 (72.2%) catheter-guided retrieval procedures for misplaced (right atrium [RA] or ventricle [RV; n = 3], superior vena cava [n = 2], brachiocephalic vein [n = 5], and subclavian vein [n = 3]) lead fragments in 16 patients were successful. Percutaneous catheter retrieval failed in five patients because there were extremely fixed or adhered lead fragments. Percutaneous transluminal angiography (PTA) of central veins for occlusion or high-grade stenosis was performed in 25 patients. In 22 of 25 patients (88%), recanalization of central veins was successful, thus enabling subsequent lead replacement. Major periprocedural complications were not observed. In the case of complicated manual PM lead implantation or revision, percutaneous catheter-guided extraction of misplaced lead fragments or recanalisation of central veins can be performed safely in the OR, thus enabling subsequent implantation or revision of PM systems in the majority of patients.
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Affiliation(s)
- Patric Kröpil
- Department of Radiology, University Hospital Düsseldorf, Düsseldorf, Germany
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Kennergren C. Cardiac implantable electronic device treatment: taking care of complications. Europace 2009; 11:1419-20. [DOI: 10.1093/europace/eup341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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