Ribeiro S, Leite L, Oliveira J, Pereira MJ, Pinheiro C, Ermida P, António N, Ventura M, Cristóvão J, Elvas L, Providência L. Transvenous removal of cardiac implantable electronic device leads.
Rev Port Cardiol 2015;
34:739-44. [PMID:
26596378 DOI:
10.1016/j.repc.2015.07.008]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 01/31/2015] [Accepted: 07/01/2015] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION AND OBJECTIVE
The number and complexity of cardiac implantable electronic devices (CIEDs) have increased, as has the number of related complications, often leading to removal of the implanted system. The aim of this study was to characterize transvenous explantation/extraction of CIED leads in a reference center.
METHODS
This was a descriptive observational study of patients consecutively admitted from January 2009 to May 2014 for transvenous lead extraction.
RESULTS
The sample consisted of 109 patients, with a mean age of 64.6±16.62 years, 73.1% male. The main indication for lead extraction was CIED infection. The mean time from first implantation to lead removal was 5.6±4.89 years. Blood cultures were positive in 32.8% of cases and 29% of patients had vegetations on echocardiography. A total of 228 cardiac leads were removed, of which 58.8% were ventricular, 32.4% atrial and 8.8% coronary sinus. Complete clinical success was achieved in 97.2% of cases, while procedural success was complete in 93.4% and partial in 5.3%. The complications reported were three cases of significant pocket hematoma, one of subclavian vein thrombosis and three of cardiac tamponade, effectively treated by pericardiocentesis.
CONCLUSIONS
Transvenous explantion or extraction of CIED leads was highly effective. A high level of experience is an essential factor in the success and safety of the procedure.
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