A single-centre experience of over one thousand lead extractions.

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Kennergren, Charles,1948Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine (author)

A single-centre experience of over one thousand lead extractions.

Article/chapterEnglish2009

Publisher, publication year, extent ...

2009-03-27
Oxford University Press (OUP),2009

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LIBRIS-ID:oai:gup.ub.gu.se/107403
https://gup.ub.gu.se/publication/107403URI
https://doi.org/10.1093/europace/eup054DOI

Supplementary language notes

Language:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

Notes

AIMS: The aim of the study was to present a single-centre experience of pacemaker and implantable cardioverter defibrillator (ICD) lead extraction using different methods, mainly laser-assisted extraction. METHODS AND RESULTS: Data from 1032 leads and 647 procedures were gathered. A step-by-step approach using different techniques while performing an ongoing risk-benefit analysis was used. The most common indications were local infection, systemic infection, non-functional lead, elective lead replacement, and J-wire fracture. Mean implantation time for all leads was 69 months and for laser-extracted leads 91 months. Laser technique was used to extract 60% of the leads, 29% were manually extracted, 6% extracted with mechanical tools, 4% were surgically removed, and 0.6% extracted by a femoral approach. Failure rate was 0.7%, and major complication rate was 0.9%. No extraction-related mortality occurred. Median time for laser extraction was 2 min. Long implantation time was not a risk factor for failure or for complication. CONCLUSION: Pacing and ICD leads can safely, successfully, and effectively be extracted. Leads can often be extracted by a superior transvenous approach; however, open-chest and femoral extractions are still required. Laser-assisted lead extraction proved to be a useful technique to extract leads that could not be removed by manual traction. The results indicate that the paradigm of abandoning redundant leads, instead of removing them, may have to be reconsidered.

Subject headings and genre

Adolescent
Adult
Aged
Aged
80 and over
Child
Defibrillators
Implantable
Device Removal
adverse effects
methods
Endpoint Determination
Equipment Failure
Female
Foreign-Body Migration
Humans
Infection Control
Male
Middle Aged
Pacemaker
Artificial
Retrospective Studies
Risk Assessment
Young Adult

Added entries (persons, corporate bodies, meetings, titles ...)

Bjurman, Christian,1983Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research(Swepub:gu)xbjuch (author)
Wiklund, Roger (author)
Gäbel, Jakob,1971Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine(Swepub:gu)xgabja (author)
Göteborgs universitetInstitutionen för medicin, avdelningen för molekylär och klinisk medicin (creator_code:org_t)

Related titles

In:Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology: Oxford University Press (OUP)11:5, s. 612-71532-2092
In:Europace: Oxford University Press (OUP)11:5, s. 612-71099-5129

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