open access

Vol 22, No 2 (2015)
Original articles
Published online: 2015-04-28
Get Citation

Lead extraction: The road to successful cardiac resynchronization therapy

Aleksander Maciąg, Paweł Syska, Maciej Sterliński, Andrzej Przybylski, Ewa Sitkowska, Artur Oręziak, Maria Bilińska, Mariusz Kuśmierczyk, Hanna Szwed
DOI: 10.5603/CJ.a2014.0064
·
Pubmed: 25299498
·
Cardiol J 2015;22(2):188-193.

open access

Vol 22, No 2 (2015)
Original articles
Published online: 2015-04-28

Abstract

Background: Still increasing life expectancy in patients with implanted devices and large number of leads more and more often induce the need to cure the treatment complications or to change especially to cardiac resynchronization therapy (CRT). In order to prevent further complications, the possibility of damaged or redundant leads extraction should be taken into consideration. The aim of the paper was to assess the effectiveness and safety of transvenous lead extraction (TLE) with co-implantation of resynchronization systems.

Methods and results: Between 2008 and March 2013, the system removal with TLE was conducted in 246 patients. In 38 patients (11 women, 28.9%), aged 43–79 (mean 65 years), it was combined with co-implantation of CRT-pacemaker or defibrillator (CRT-P/D). Indica­tions for TLE covered: lead failure in 21 (55.3%) patients, redundant leads in 6 (15.8%), and the occluded venous system in 7 (18.4%). The up-grade of the pacemaker or defibrillator system to CRT-D was performed in 19 cases, CRT-P/D revision in next 19. Together 32 defibrillation leads and 42 pacing leads (27 left ventricular leads, and 1 epicardial lead) were implanted. The intended clinical target — an effective resynchronization therapy — was obtained in all patients. There was no case of death or severe complications. In 2 cases of venous occlusion, the implantation on the contralateral side was required.

Conclusions: TLE enables effective resynchronization therapy also in the case of the presence of too many leads, occlusion of the venous system or lead failure. Significant technical problems can occur especially in patients with venous system occlusion.

Abstract

Background: Still increasing life expectancy in patients with implanted devices and large number of leads more and more often induce the need to cure the treatment complications or to change especially to cardiac resynchronization therapy (CRT). In order to prevent further complications, the possibility of damaged or redundant leads extraction should be taken into consideration. The aim of the paper was to assess the effectiveness and safety of transvenous lead extraction (TLE) with co-implantation of resynchronization systems.

Methods and results: Between 2008 and March 2013, the system removal with TLE was conducted in 246 patients. In 38 patients (11 women, 28.9%), aged 43–79 (mean 65 years), it was combined with co-implantation of CRT-pacemaker or defibrillator (CRT-P/D). Indica­tions for TLE covered: lead failure in 21 (55.3%) patients, redundant leads in 6 (15.8%), and the occluded venous system in 7 (18.4%). The up-grade of the pacemaker or defibrillator system to CRT-D was performed in 19 cases, CRT-P/D revision in next 19. Together 32 defibrillation leads and 42 pacing leads (27 left ventricular leads, and 1 epicardial lead) were implanted. The intended clinical target — an effective resynchronization therapy — was obtained in all patients. There was no case of death or severe complications. In 2 cases of venous occlusion, the implantation on the contralateral side was required.

Conclusions: TLE enables effective resynchronization therapy also in the case of the presence of too many leads, occlusion of the venous system or lead failure. Significant technical problems can occur especially in patients with venous system occlusion.

Get Citation

Keywords

lead extraction, cardiac resynchronization therapy, central venous occlusion, lead failure

About this article
Title

Lead extraction: The road to successful cardiac resynchronization therapy

Journal

Cardiology Journal

Issue

Vol 22, No 2 (2015)

Pages

188-193

Published online

2015-04-28

DOI

10.5603/CJ.a2014.0064

Pubmed

25299498

Bibliographic record

Cardiol J 2015;22(2):188-193.

Keywords

lead extraction
cardiac resynchronization therapy
central venous occlusion
lead failure

Authors

Aleksander Maciąg
Paweł Syska
Maciej Sterliński
Andrzej Przybylski
Ewa Sitkowska
Artur Oręziak
Maria Bilińska
Mariusz Kuśmierczyk
Hanna Szwed

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl