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The Implantation of New Leads after Extraction

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Transvenous Lead Extraction

Abstract

The natural consequence of lead extraction procedures is the need for a subsequent device reimplantation. For this reason, when an extraction procedure is planned, the patient should be aware of the potential risks and complications related to both procedures and should be informed of potential alternatives in case of transvenous reimplantation failure. Reimplantation is not necessary in all the patients. The need for reimplantation after lead extraction cannot be always predicted before pacing/ defibrillating system removal. In previous published studies, reimplantation rate has been reported to vary from 48% to 87% of cases [1]–[3]; in our experience, according with other centers, reimplantation of a new device is usually not required in about 20% of patients [4], [5]. However, in all patients undergoing lead extraction, especially in case of previous infection, the ongoing need of a cardiac device should be reassessed [6].

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References

  1. Bohm A, Banyai F, Preda I et al (1996) The treatment of septicemia in pacemaker patients. Pacing Clin Electrophysiol 19:1105–1011

    Article  PubMed  CAS  Google Scholar 

  2. Dy Chua J, Wilkoff BL, Lee I et al (2000) Diagnosis and management of infections involving implantable electrophysiologic cardiac devices. Ann Intern Med 133:604–608

    PubMed  CAS  Google Scholar 

  3. Cacoub P, Leprince P, Nataf P et al (1998) Pacemaker infective endocarditis. Am J Cardiol 82:480–484

    Article  PubMed  CAS  Google Scholar 

  4. Sohail MR, Uslan DZ, Khan AH et al (2007) Management and outcome of permanent pacemaker and implantable cardioverter-defibrillator infections. J Am Coll Cardiol 49:1851–1859

    Article  PubMed  Google Scholar 

  5. Tascini C, Bongiorni MG, Gemignani G et al (2006) Management of cardiac device infections: a retrospective survey of a non surgical approach combining antibiotic therapy with transvenous removal. J Chem 18(2):157–163

    CAS  Google Scholar 

  6. Wilkoff BL, Love CJ, Byrd CL et al (2009) Transvenous lead extraction: Heart Rhythm Society expert consensus on facilities, training, indications, and patient management. Heart Rhythm 6(7):1085–1104

    Article  PubMed  Google Scholar 

  7. Bongiorni MG, Di Cori A, Soldati E et al (2008) Intracardiac echocardiography in patients with pacing and defibrillating leads: a feasibility study. Echocardiography 25:632–638

    Article  PubMed  Google Scholar 

  8. Tarakji KG, Chan EJ, Cantillon DJ et al (2010) Cardiac implantable electronic device infections: Presentation, management, and patient outcomes. Heart Rhythm 7(8):104–1047

    Article  Google Scholar 

  9. Borek PP, Wilkoff BL (2008) Pacemaker and ICD leads: Strategies for long-term management. J Interv Card Electrophysiol 23(1):59–72

    Article  PubMed  Google Scholar 

  10. Byrd C (2000) Management of implant complications. In: Ellenbogen K, Kay G, Wilkoff BL, eds. Clinical cardiac pacing, 2nd edn. WB Saunders, Philadelphia, pp 669–694

    Google Scholar 

  11. Nandyala R, Parsonnet V (2006) One stage side-to-side replacement of infected pulse generators and leads. Pacing Clin Electrophysiol 29:393–396

    Article  PubMed  Google Scholar 

  12. Klug D, Balde M, Pavin D et al (2007) Risk factors related to infections of implanted pacemakers and cardioverter-defibrillators results of a large prospective study. Circulation 116:1349–1355

    Article  PubMed  Google Scholar 

  13. Mathur G, Stables RH, Heaven D et al (2001) Permanent pacemaker implantation via the femoral vein: an alternative in cases with contraindications to the pectoral approach. Europace 3:56–59

    Article  PubMed  CAS  Google Scholar 

  14. Ellestad MH, French J (1989) Iliac vein approach to permanent pacemaker implantation. Pacing Clin Electrophysiol 12:1030–1033

    Article  PubMed  CAS  Google Scholar 

  15. Burke MC, Stobie P, Tierney SP et al (2003) Time to reimplantation after device system extraction, pocket excision and primary closure in localized pocket infection. Pacing Clin Electrophysiol 26:36 [abstract]

    Article  Google Scholar 

  16. De Voogt G, Ruiter JH (2006) Occlusion of the coronary sinus: a complication of resynchronization therapy for severe heart failure. Europace 8:456–458

    Article  PubMed  Google Scholar 

  17. Zucchelli G, Solarino S, Soldati E et al (2009) Cardiac resynchronization therapy after left ventricular lead extraction: feasibility and outcome of conventional transvenous approach. Heart Rhythm 6:S256[abstract]

    Google Scholar 

  18. Zucchelli G, Soldati E, Segreti L et al (2008) Cardiac resynchronization after left ventricular lead extraction: usefulness of angioplasty in coronary sinus stenosis. Pacing Clin Electrophysiol 31:908–911

    Article  PubMed  Google Scholar 

  19. Kowalski O, Lenarczyk R, Prokopczuk J et al (2006) Effect of percutaneous interventions within the coronary sinus on the success rate of the implantations of resynchronization pacemakers. Pacing Clin Electrophysiol 26:1075–1080

    Article  Google Scholar 

  20. Worley SJ, Gohn DC, Pulliam RW (2008) Focused force coronary venoplasty to eliminate a refractory stenosis preventing LV lead placement in two patients. Pacing Clin Electrophysiol 31(11):1503–1505

    Article  PubMed  Google Scholar 

  21. Worley SJ, Gohn DC, Pulliam RW (2008) Coronary vein rupture during venoplasty for LV lead placement. Pacing Clin Electrophysiol 31(7):904–907

    Article  PubMed  Google Scholar 

  22. Silvetti MS, Drago F (2008) Outcome of young patients with abandoned, nonfunctional endocardial leads. Pacing Clin Electrophysiol 31:473–479

    Article  PubMed  Google Scholar 

  23. Suga C, Hayes DL, Hyberger LK et al (2000) Is there an adverse outcome from abandoned pacing leads? J Interv Card Electrophysiol 4:493–499

    Article  PubMed  CAS  Google Scholar 

  24. Bohm A, Pinter A, Duray G et al (2001) Complications due to abandoned not infected pacemaker leads. Pacing Clin Electrophysiol 24:1721–1724

    Article  PubMed  CAS  Google Scholar 

  25. Harada Y, Katsume A, Kimata M et al (2005) Placement of pacemaker leads via the extrathoracic subclavian vein guided by fluoroscopy and venography in the oblique projection. Heart Vessels 20(1):19–22

    Article  PubMed  Google Scholar 

  26. Pace JN, Maquilan M, Hessen SE et al (1997) Extraction and replacement of permanent pacemaker leads through occluded vessels: use of extraction sheaths as conduits-balloon venoplasty as an adjunct. J Interv Card Electrophysiol 1:271–279

    Article  PubMed  CAS  Google Scholar 

  27. Ing FF, Mullins CE, Grifka RG et al (1998) Stent dilation of superior vena cava and innominate vein obstructions permits transvenous pacing lead implantation. Pacing Clin Electrophysiol 21(8):1517–1530

    Article  PubMed  CAS  Google Scholar 

  28. Smith MC, Love CJ (2008) Extraction of transvenous pacing and ICD leads. Pacing Clin Electrophysiol 31:736–752

    Article  PubMed  Google Scholar 

  29. Rinaldi CA, Simon RD, Geelen P et al (2003) A randomized prospective study of single coil versus dual coil defibrillation in patients with ventricular arrhythmias undergoing implantable cardioverter defibrillator therapy. Pacing Clin Electrophysiol 26:1684–1690

    Article  PubMed  Google Scholar 

  30. Wilkoff BL, Belott PH, Love CJ et al (2005) Improved extraction of ePTFE and medical adhesive modified defibrillation leads from the coronary sinus and great cardiac vein. Pacing Clin Electrophysiol 28:205–211

    Article  PubMed  Google Scholar 

  31. Hackler JW, Sun Z, Lindsay BD et al (2010) Effectiveness of implantable cardioverter defibrillator lead coil treatments in facilitating ease of extraction. Heart Rhythm 7(7):890–897

    Article  PubMed  Google Scholar 

  32. Bongiorni MG, Soldati E, Zucchelli G et al (2008) Transvenous removal of pacing and implantable cardiac defibrillating leads using single sheath mechanical dilatation and multiple venous approaches: high success rate and safety in more than 2000 leads. Eur Heart J 29:2886–2893

    Article  PubMed  Google Scholar 

  33. Bongiorni MG, Di Cori A, Zucchelli G et al (2010) A modified transvenous single mechanical dilatation technique to remove a chronically implanted active-fixation coronary sinus pacing lead. Pacing Clin Electrophysiol [Epub ahead of print]

    Google Scholar 

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Zucchelli, G., Soldati, E. (2011). The Implantation of New Leads after Extraction. In: Bongiorni, M.G. (eds) Transvenous Lead Extraction. Springer, Milano. https://doi.org/10.1007/978-88-470-1466-4_9

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  • DOI: https://doi.org/10.1007/978-88-470-1466-4_9

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1465-7

  • Online ISBN: 978-88-470-1466-4

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