Extraction of endocardial implantable cardioverter-defibrillator leads

Franc, P. Le; Klug, Didier; Jarwe, Mustapha; Lacroix, Dominique; Delfaut, Philippe; Kouakam, Claude; Kacet, Salem

doi:10.1016/s0002-9149(99)00232-5

Cited by 25 publications

(15 citation statements)

References 12 publications

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“…The most important difficulties in removing ICD leads compared to pacemaker leads consists of the encasement of the proximal defibrillation coil at the junction between the superior vena cava and the innominate vein, and the dense adhesion of the distal coil involving the tricuspid valve 41 . It also appears that ICD lead tips are encased by denser scarring than pacemaker leads perhaps because ICD leads are heavier and bigger than pacemaker leads 41 . Thus, the time from implant is a decisive factor to judge the potential efficacy of lead extraction 42 .…”

Section: Lead Extractionmentioning

confidence: 99%

ICD Leads:

Gradaus

Breithardt

Böcker

2003

Pacing Clinical Electrophis

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The treatment of ventricular tachyarrhythmias has changed over the last 10 years. Implantable cardioverter defibrillators (ICDs), once used only as a last resort therapy, have now become the treatment of choice. This change occurred before the first results of randomized studies on ICD therapy in patients with life-threatening ventricular tachyarrhythmias were published by the end of 1997. Technological advances of ICD therapy, in particular the development of transvenous leads, were to a large extent responsible for this change. Modern leads are characterized by their multilumen design that incorporates straight wires and coiled conductors into a single electrode body. Conductors and insulation are sheathed with additional insulation layers. The most frequently used insulating materials are silicone, polyurethane, and fluoropolymers. Lead failures are an important complication of ICD therapy. Fractured conductors, compression, creeping, or insulation defects from abrasion can cause such lead dysfunctions. Chronically implanted leads will inevitably have an increased risk of failure due to defects despite all technological advances. In the light of improving survival figures in patients with ventricular tachyarrhythmias and increasing numbers of ICD implantations, lead failures are becoming a clinical problem of ever increasing importance. Therefore, the question of which lead types necessitate extraction when a certain failure occurs and which leads can be left in place. Despite continuous improvements in lead extraction systems and growing experience in their use, the extraction of any pacemaker or ICD lead is associated with some risk of complications.

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Section: Lead Extractionmentioning

confidence: 99%

ICD Leads:

Gradaus

Breithardt

Böcker

2003

Pacing Clinical Electrophis

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“…The two factors associated with the leads seem intuitivegreater time after implantation results in progressive fibrosis at sites of contact between the lead and the vessel wall. ICD leads have a larger diameter than pacing leads, providing a larger surface area for fibrosis; the shocking coils are commonly involved with fibrosis, causing them to adhere to the wall of the vein (8).…”

Section: Discussionmentioning

confidence: 99%

Arrhythmia device lead extraction: Factors that necessitate laser assistance

Gula¹,

Krahn²,

Yee³

et al. 2008

Canadian Journal of Cardiology

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“…Le Franc et al reported no complications using conventional sheaths [42] . Krishnan et al reported a fatal pericardial tamponade in one patient during laser sheath extraction [43] .…”

Section: Extraction Of Icd Leadsmentioning

confidence: 97%

“…Until now, extraction of ICD leads has only been reported in limited numbers of patients [41][42][43][44][45] . Le Franc et al reported successful endovascular extraction of 13 defibrillation leads in 11 patients with conventional extraction techniques [42] .…”

Section: Extraction Of Icd Leadsmentioning

confidence: 99%

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Malfunction of endocardial defibrillator leads and lead extraction: where do they meet?

2002

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From this overview we conclude that malfunctioning pace-sense or ICD leads can be left in situ if there are no uncovered insulation defects. Inserting a new pace-sense or ICD lead is preferable in this situation given the current known complication rate of lead extraction. Lead extraction should be reserved for damaged leads in which interference with proper detection or defibrillation of newly inserted leads cannot be excluded.

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Extraction of endocardial implantable cardioverter-defibrillator leads

Cited by 25 publications

References 12 publications

ICD Leads:

ICD Leads:

Arrhythmia device lead extraction: Factors that necessitate laser assistance

Malfunction of endocardial defibrillator leads and lead extraction: where do they meet?

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