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Predicting the difficulty of a transvenous lead extraction procedure: Validation of the LED index 下载免费PDF全文
Luca Bontempi MD Francesca Vassanelli MD Manuel Cerini MD Lorenza Inama MD Francesca Salghetti MD Daniele Giacopelli MSc Alessio Gargaro MSc Abdallah Raweh MD Antonio Curnis MD 《Journal of cardiovascular electrophysiology》2017,28(7):811-818
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Carola Gianni MD Mohanad Elchouemi BS Rami Helmy Lauryn Spinetta BS Vincenzo Mirco La Fazia MD Nicola Pierucci MD Issa Asfour MD Domenico G. Della Rocca MD Sanghamitra Mohanty MD Mohamed A. Bassiouny MD Paul C. Coffeen MD Patrick M. Hranitzky MD Robert C. Neely MD Andrea Natale MD Robert C. Canby MD Amin Al-Ahmad MD 《Journal of cardiovascular electrophysiology》2024,35(2):278-287
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Khairy P Roux JF Dubuc M Thibault B Guerra PG Macle L Mercier LA Dore A Roy D Talajic M Pagé P 《Journal of cardiovascular electrophysiology》2007,18(5):507-511
Background: In adults with congenital heart disease (ACHD), lead extraction procedures are expected to parallel increasing transvenous pacemaker and defibrillator implantations. We sought to assess the safety and feasibility of laser lead extraction in ACHD.
Methods and Results: All laser lead extractions (Spectranectics, Colorado Springs, CO, USA) performed at the Montreal Heart Institute between September 2000 and August 2005 were prospectively registered. Efficacy and complications in patients with ACHD were compared to the larger cohort. Laser lead extraction was attempted on 270 leads in 175 patients. In ACHD, 23 (five atrial, 15 ventricular pacing, and three defibrillator) leads were targeted in 16 patients. Indications were: infection 44%, dysfunction 25%, upgrade 25%, and pain 6%. Patients with ACHD were younger (43.0 ± 13.5 vs 63.7 ± 14.7 years, P < 0.0001) and had a higher proportion of active fixation leads (74% vs 37%, P = 0.0013). Lead age in patients with and without ACHD was 9.0 ± 5.2 vs 7.7 ± 5.2 years (P = 0.2713). Overall, 21 of 23 leads (91%) were successfully extracted in ACHD compared with 220 of 247 leads (89%) (P = 0.7405). One major complication (6.3%) occurred in ACHD (tricuspid valve laceration) compared with five major (3.0%) and eight minor (5.0%) complications in patients without ACHD. Presence of ACHD did not modulate procedural success (OR 1.3, 95% CI [0.3, 5.8]) or complications (OR 1.0, 95% CI [0.2, 4.4]). Median procedural time was 27 minutes longer in ACHD (127 vs 100 minutes, P = 0.0595).
Conclusion: In selected patients with ACHD, laser lead extraction may be performed with a safety and efficacy profile comparable to patients without ACHD. 相似文献
Methods and Results: All laser lead extractions (Spectranectics, Colorado Springs, CO, USA) performed at the Montreal Heart Institute between September 2000 and August 2005 were prospectively registered. Efficacy and complications in patients with ACHD were compared to the larger cohort. Laser lead extraction was attempted on 270 leads in 175 patients. In ACHD, 23 (five atrial, 15 ventricular pacing, and three defibrillator) leads were targeted in 16 patients. Indications were: infection 44%, dysfunction 25%, upgrade 25%, and pain 6%. Patients with ACHD were younger (43.0 ± 13.5 vs 63.7 ± 14.7 years, P < 0.0001) and had a higher proportion of active fixation leads (74% vs 37%, P = 0.0013). Lead age in patients with and without ACHD was 9.0 ± 5.2 vs 7.7 ± 5.2 years (P = 0.2713). Overall, 21 of 23 leads (91%) were successfully extracted in ACHD compared with 220 of 247 leads (89%) (P = 0.7405). One major complication (6.3%) occurred in ACHD (tricuspid valve laceration) compared with five major (3.0%) and eight minor (5.0%) complications in patients without ACHD. Presence of ACHD did not modulate procedural success (OR 1.3, 95% CI [0.3, 5.8]) or complications (OR 1.0, 95% CI [0.2, 4.4]). Median procedural time was 27 minutes longer in ACHD (127 vs 100 minutes, P = 0.0595).
Conclusion: In selected patients with ACHD, laser lead extraction may be performed with a safety and efficacy profile comparable to patients without ACHD. 相似文献
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Robert K. Lewis Sean D. Pokorney Donald D. Hegland Jonathan P. Piccini 《Journal of cardiovascular electrophysiology》2020,31(7):1801-1808
Due to the growing number of patients treated with cardiac implantable electronic devices (CIEDs) there is an increased need for lead management, evaluation, and extraction. While CIED lead extraction has many indications, a consistent approach to preprocedural planning should be applied in all cases, including a thorough consultation with careful review of the patient's medical and device history, as well as a discussion of informed consent and shared decision‐making with the patient and their loved ones. The use of chest X‐ray, echocardiography, and computed tomography (CT) scan can further help with risk stratification and procedural planning. Intraprocedural echocardiography (transesophageal or intracardiac) is recommended and allows early recognition of cardiothoracic injury. Establishing an extraction team with cardiology/electrophysiology, anesthesiology, and CT surgery is is crucial to a successful and safe CIED extraction practice, including immediately available surgical backup. This hands‐on review will address how to approach patients who are undergoing lead extraction, as well as several innovations in preprocedure and intraprocedural risk assessment. 相似文献
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Robert K. Lewis Wendy L. Ehieli Donald D. Hegland Sean D. Pokorney Hamid Chalian Reggy Iranmanesh Lynne M. Hurwitz Koweek Jonathan P. Piccini 《Journal of cardiovascular electrophysiology》2020,31(3):723-732
Cardiac implantable electronic devices (CIEDs) frequently need to be extracted due to infection, hardware failure, and other causes. The extraction of the CIED is typically performed using percutaneous methods. While these procedures are mostly performed without incident there is a small risk of significant complications. Dedicated imaging pre‐CEID removal to include the central veins and heart with multidetector computed tomography (MDCT) can be utilized to evaluate the lead course and termination, the integrity of the central veins and cardiac chambers, and identify potential complications that may alter the lead extraction procedure as well as reimplantation of subsequent leads. Indications for preprocedural imaging, the technique of dedicated preprocedural lead extraction MDCT, and the approach to the interpretation of the images is discussed in this review. 相似文献
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Federico Migliore MD PhD FESC FEHRA Raimondo Pittorru MD Pietro Bernardo Dall'Aglio MD Manuel De Lazzari MD Giovanni Rovaris MD Elena Piazzi MD Alessia Dentico CCP Alessandra Ferrieri CCP Giuseppe D'Angelo MD Alessandra Marzi MD Basma El Sawaf CCP Emanuele Bertaglia MD PhD Sabino Iliceto MD Gino Gerosa MD Vincenzo Tarzia MD PhD Domenico Carretta MD Patrizio Mazzone MD 《Journal of cardiovascular electrophysiology》2023,34(3):728-737
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Carola Gianni Robert C. Canby Domenico G. Della Rocca Andrea Natale Amin Al-Ahmad 《Journal of cardiovascular electrophysiology》2021,32(8):2337-2339
Herein, we present a case of laser-assisted extraction of a retained lead remnant following incomplete removal of an implantable cardiac defibrillator system implanted via a left femoral approach. 相似文献
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Simon Pecha MD Da-Un Chung MD Heiko Burger MD Brigitte Osswald MD PhD Naser Ghaffari MD Michael Knaut MD Hermann Reichenspurner MD PhD Stephan Willems MD Christian Butter MD Samer Hakmi MD GALLERY investigators 《Journal of cardiovascular electrophysiology》2023,34(9):1951-1960