Nonthoracotomy Implantable Defibrillator Lead Extraction:. Results and Comparison with Extraction of Pacemaker Leads
- 1 October 2003
- journal article
- research article
- Published by Wiley in Pacing and Clinical Electrophysiology
- Vol. 26 (10), 1944-1950
- https://doi.org/10.1046/j.1460-9592.2003.00300.x
Abstract
Extraction of pacemaker leads has been demonstrated to be successful and safe in experienced hands using current tools. Whether application of such techniques and tools yield similar results among patients undergoing extraction of nonthoracotomy implantable defibrillator leads is unknown. This report describes a retrospective analysis of indications, techniques used, and outcome of patients who had a single ventricular nonthoracotomy implantable defibrillator lead extracted at The Cleveland Clinic Foundation. Results were compared to a matched population of patients undergoing extraction of ventricular pacemaker leads from a national registry and to the experience with pacemaker lead extraction at The Cleveland Clinic Foundation. Successful complete extraction of ventricular nonthoracotomy implantable defibrillator leads, in the absence of major complications, was achieved in 96.9% of attempts to extract leads from 161 patients. Clinical success was achieved in 98.1% of patients. Failure occurred in three patients. Two patients had major complications, including one death. The most common indication for extraction was infection (46.6%), followed by lead failure (34.2%). Procedure (140.8 vs 171.2 minutes, P<0.01) and fluoroscopy (9.9 vs 11.0 minutes, P<0.01) times compared favorably with those obtained from the pacemaker lead extraction database. Use of LASER did not influence the safety of the procedure or fluoroscopy times. Extraction of ventricular nonthoracotomy implantable defibrillator leads using currently available tools is a complex but effective procedure. In experienced hands, excellent success rates should be achieved with a low incidence of complications.Keywords
This publication has 23 references indexed in Scilit:
- Recommendations for Extraction of Chronically Implanted Transvenous Pacing and Defibrillator Leads: Indications, Facilities, TrainingPacing and Clinical Electrophysiology, 2000
- Canadian Implantable Defibrillator Study (CIDS)Circulation, 2000
- CURRENT CONCEPTS IN EXTRACTION OF TRANSVENOUS PACING AND ICD LEADSCardiology Clinics, 2000
- A Randomized Study of the Prevention of Sudden Death in Patients with Coronary Artery DiseaseThe New England Journal of Medicine, 1999
- Intravascular Extraction of Problematic or Infected Permanent Pacemaker Leads: 1994–1996Pacing and Clinical Electrophysiology, 1999
- Pacemaker lead extraction with the laser sheath: results of the pacing lead extraction with the excimer sheath (PLEXES) trialJournal of the American College of Cardiology, 1999
- Initial experience with a laser sheath to extract chronic transvenous implantable cardioverter-defibrillator leadsThe American Journal of Cardiology, 1998
- A Comparison of Antiarrhythmic-Drug Therapy with Implantable Defibrillators in Patients Resuscitated from Near-Fatal Ventricular ArrhythmiasThe New England Journal of Medicine, 1997
- Improved Survival with an Implanted Defibrillator in Patients with Coronary Disease at High Risk for Ventricular ArrhythmiaThe New England Journal of Medicine, 1996
- Lead ExtractionCardiology Clinics, 1992