Extraction of superfluous device leads: A comparison with removal of infected leads

被引:11
作者
Huang, Xin-Miao [1 ,2 ]
Fu, Haixia [2 ,3 ]
Osborn, Michael J. [2 ]
Asirvatham, Samuel J. [2 ]
McLeod, Christopher J. [2 ]
Glickson, Michael [4 ,5 ]
Acker, Nancy G. [2 ]
Friedman, Paul A. [2 ]
Cha, Yong-Mei [2 ]
机构
[1] Second Mil Med Univ, Changhai Hosp, Dept Cardiovasc Dis, Shanghai, Peoples R China
[2] Mayo Clin, Div Cardiovasc Dis, Rochester, MN 55905 USA
[3] Zhengzhou Univ, Henan Prov Peoples Hosp, Dept Cardiovasc Dis, Zhengzhou, Henan, Peoples R China
[4] Chaim Sheba Med Ctr, Heart Ctr, Davidai Arrhythmia Ctr, IL-52621 Tel Hashomer, Israel
[5] Tel Aviv Univ, Tel Hashomer, Israel
关键词
Cardiovascular implantable electronic device; Complication; Lead extraction; Outcome; Tricuspid regurgitation; GO CURRENT CONTROVERSIES; DEFIBRILLATOR LEADS; TRANSVENOUS PACEMAKER; SINGLE-CENTER; LASER SHEATH; EXPERIENCE; MANAGEMENT; OUTCOMES; DEFECTS; STAY;
D O I
10.1016/j.hrthm.2015.02.005
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND Although increasingly more Lead extraction was performed for superfluous leads, the extraction of such leads remains controversial. OBJECTIVE The objective of this study was to determine the outcomes and complications of transvenous extraction of superfluous leads in a single center in the era of laser technology. METHODS Four hundred eighty transvenous Lead extraction procedures performed from January 2001 through October 2012 at Mayo Clinic (Rochester, Minnesota) were retrospectively reviewed. Of these, 123 procedures were performed for superfluous functional or nonfunctional leads. Data were collected from electronic medical records and an institutional database of cardiovascular implantable electronic devices. RESULTS A total of 167 superfluous Leads (mean [SD] Lead duration 53 [53] months; median 34 months) were removed during the 123 procedures. Forty-one percent of procedures were for lead malfunction. The procedural complete-success rate was 96.7%. Major complications occurred in 1 patient (0.8%), who had a superior vena cava tear that required thoracotomy. Superfluous leads had been implanted for a shorter period of time than infected leads (mean [SD] 53 [53] vs 81 [59] months; P < .001). The procedural completesuccess rate was higher for the removal of superfluous Leads than for Leads associated with infection (97% vs 92%; P = .05). CONCLUSION Transvenous extraction of superfluous Leads is highly successful, with few procedural complications. Extraction of superfluous leads at the time of device upgrade or lead revision is considered reasonable to avoid the increasing risk of extraction complications with Lead aging.
引用
收藏
页码:1177 / 1182
页数:6
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