open access

Vol 59, No 1 (2000)
ORIGINAL ARTICLES
Published online: 2000-02-16
Submitted: 2012-02-06
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The morphological conditions of the permanent pacemaker lead extraction

Dariusz Kozłowski, Ada Dubaniewicz, Edward Koźluk, Marek Grzybiak, Wojciech Krupa, Piotr Kołodziej, Anna Pazdyga, Monika Adamowicz-Kornacka, Ewa Walczak, Franciszek Walczak
Folia Morphol 2000;59(1):25-29.

open access

Vol 59, No 1 (2000)
ORIGINAL ARTICLES
Published online: 2000-02-16
Submitted: 2012-02-06

Abstract

Pacemaker lead extraction is the treatment of choice in infectious complications regarding implantation procedure. The purpose of this study was to estimate the safety of the extraction in relation to the morphological changes of the pacing electrode. Research was carried out on materials consisting of 60 human hearts from 45 to 95 years of age (average 63 ± 15 yrs), with VVI or DDD pacing (pacing duration 84 ± 26 months) fixed in a formalin solution. Classical macroscopic anatomical methods were applied.
In 44 hearts (73.3%) from the investigated group the posterior tricuspid leaflet was thickened only, and in 24 of these hearts the process regarded not only posterior leaflet but also the septal one and especially commissure between them. In 52 hearts (86.6%) inflammatory reaction spread also to the neighboring part of the electrode. The length of the neointima-inflammatory tissue ranged from 4 to 8 mm (average 5 ± 2 mm). On the tip of the electrode in the right ventricle cavity in 56 hearts (93.3%) we observed that endocardial leads were surrounded by fibrous thickening , and partially covered by endocardial tissue.
We concluded that from the anatomical point of view the extraction of the pacing electrode seems to be questionable, especially in long-term permanent pacing. The experimental traction shows that only recently implanted electrodes were removed without any complications and in others with fraction of the tip, myocardial tissue avulsion or such removal was not successful at all.

Abstract

Pacemaker lead extraction is the treatment of choice in infectious complications regarding implantation procedure. The purpose of this study was to estimate the safety of the extraction in relation to the morphological changes of the pacing electrode. Research was carried out on materials consisting of 60 human hearts from 45 to 95 years of age (average 63 ± 15 yrs), with VVI or DDD pacing (pacing duration 84 ± 26 months) fixed in a formalin solution. Classical macroscopic anatomical methods were applied.
In 44 hearts (73.3%) from the investigated group the posterior tricuspid leaflet was thickened only, and in 24 of these hearts the process regarded not only posterior leaflet but also the septal one and especially commissure between them. In 52 hearts (86.6%) inflammatory reaction spread also to the neighboring part of the electrode. The length of the neointima-inflammatory tissue ranged from 4 to 8 mm (average 5 ± 2 mm). On the tip of the electrode in the right ventricle cavity in 56 hearts (93.3%) we observed that endocardial leads were surrounded by fibrous thickening , and partially covered by endocardial tissue.
We concluded that from the anatomical point of view the extraction of the pacing electrode seems to be questionable, especially in long-term permanent pacing. The experimental traction shows that only recently implanted electrodes were removed without any complications and in others with fraction of the tip, myocardial tissue avulsion or such removal was not successful at all.
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Keywords

anatomical conditions of extraction; morphology of the permanent pacing electrodes; functionless chronic leads

About this article
Title

The morphological conditions of the permanent pacemaker lead extraction

Journal

Folia Morphologica

Issue

Vol 59, No 1 (2000)

Pages

25-29

Published online

2000-02-16

Bibliographic record

Folia Morphol 2000;59(1):25-29.

Keywords

anatomical conditions of extraction
morphology of the permanent pacing electrodes
functionless chronic leads

Authors

Dariusz Kozłowski
Ada Dubaniewicz
Edward Koźluk
Marek Grzybiak
Wojciech Krupa
Piotr Kołodziej
Anna Pazdyga
Monika Adamowicz-Kornacka
Ewa Walczak
Franciszek Walczak

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