Lead Extraction Is Preferred for Lead Revisions and  System Upgrades: When Less Is More

Maytin, Melanie; Epstein, Laurence M.; Henrikson, Charles A.

doi:10.1161/circep.110.954107

Cited by 106 publications

(75 citation statements)

References 90 publications

(101 reference statements)

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“…20 Devicerelated infection has been shown to be an important indicator of higher mortality, with a mortality as high as 66% reported in untreated patients versus 18% following extraction and antibiotic treatment. 21 This potentially high mortality explains the drive behind the 2 patients in our series who underwent elective sternotomies to ensure complete removal and improve long-term survival. 19,20 The removal of all infected devices and proximal material is vital to prevent reoccurrence of bacteremia or the development of endocarditis.…”

Section: Discussionmentioning

confidence: 93%

Creation of the sole regional laser lead extraction program serving Atlantic Canada: initial experience

Williams

O’Keefe

Légaré

2016

cjs

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Section: Discussionmentioning

confidence: 93%

Creation of the sole regional laser lead extraction program serving Atlantic Canada: initial experience

Williams

O’Keefe

Légaré

2016

cjs

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“…Schaut man sich die Literatur der letzten 20 Jahre an, so liegen die angegebenen Erfolgsraten bei 85% bis 100%. Wirft man einen Blick nur auf die letzten beiden Jahre, so werden in 95% bis 100% der Fälle erfolgreiche Sondenextraktionen berichtet [1,[10][11][12][13][14].…”

Section: A B Wie Hoch Ist Die Erfolgsrate?unclassified

“…Ein Mittelwert aus mehreren Studien erbringt eine Mortalität von 0,4%. Der prozentuale Anteil an schwerwiegenden Komplikationen wird in der Literatur mit 0,3-7%, im Mittel mit 1,8% angegeben [1,9,[10][11][12][13][14].…”

Section: Wie Hoch Ist Das Risiko?unclassified

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Sondenextraktionen eine anspruchsvolle Aufgabe

2011

Cardiovasc Med

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Lead extraction, a demanding task: Every year approximately 1 0 000-15 000 pacemakerand ICD-leads are extracted worldwide with numbers continuing to rise. The increasing need for lead extractions may be explained by the evolution of pacemakerand ICD-implants during the last decade as well as by the widened spectrum of extraction devices and techniques. Last but not least, in 2009 the indications for transvenous lead extractions were broadened by the Heart Rhythm Society. Lead extraction are not simple operations at all, but instead can be very challenging with a recognisable risk profile. When carried out by specialised centres lead extractions may be performed with high success rates (>95%), and low complication rates (<2%) and mortality (<0.5%).

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“…This is a complex surgical procedure, with unavoidable risks, including possible tearing of the surrounding blood vessel or perforating the heart. [14][15][16] The concept of a self-contained leadless pacemaker (LP) was first reported in 1970. 17 However, the battery did not last more than a few weeks.…”

mentioning

confidence: 99%

The Promise of Leadless Pacing: Based on Presentations at Nanostim Sponsored Symposium Held at the European Society of Cardiology Congress 2013, Amsterdam, The Netherlands, 2 September 2013

Knops¹,

Sperzel²,

Neužil³

2011

Arrhythmia &Amp; Electrophysiology Review

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In 1958, the world's first patient was implanted with a pacemaker.It brought numerous benefits, the most important of which was increased survival. Since then, pacemaker technology has evolved with the development of improved device longevity, by including a high-energy density battery and utilising high impedance, low threshold leads. Implantable pulse generators (IPGs) for cardiac arrhythmias are now a proven and widely used treatment method. A worldwide cardiac pacing and implantable cardioverter-defibrillator (ICD) survey found that in 2009 there were over 700,000 new implants, with the majority of these implants being performed in the US and Europe, but the greatest growth occurring in Asia. 1Despite new developments in pacemaker technology, there is still a high incidence of pacemaker-related complications.2 A large prospective multicentre study found that after two months 12 % of patients present with acute complications (see Figure 1).3 Chronic complications subsequently occur in 10 % of patients. Most of these complications are related to the lead or the surgical pocket created to hold the pacemaker.Local pocket-related complications include haematoma, wound pain, decreased mobility, pocket erosion and infection. Pocket infection can be a serious complication, which occurs in 0.5-1.5 % of implants, but has a mortality of 10 %. Staphylococcus aureus is the main source of infection and is becoming increasingly antibiotic resistant. Pocket haematoma is also a relatively common complication. It is usually benign and treated conservatively but sometimes requires repeated surgery, which can be a major issue in patients who use anticoagulant drugs. 4,5 However, the greatest potential for a complication in a pacemaker procedure is related to the lead. The overall incidence of clinical problems related to the lead is around 8 %.6 Mechanical failure and lead dislodgement are relatively common complications. AbstractPacemaker technologies have advanced dramatically over the decades since they were first introduced, and every year many thousands of new implants are performed worldwide. However, there continues to be a high incidence of acute and chronic complications, most of which are linked to the lead or the surgical pocket created to hold the device. A leadless pacemaker offers the possibility of bypassing these complications, but requires a catheter-based delivery system and a means of retrieval at the end of the device's life, as well as a way of repositioning to achieve satisfactory pacing thresholds and R waves, a communication system and low peak energy requirements.A completely self-contained leadless pacemaker has recently been developed, and its key characteristics are discussed, along with the results of an efficacy and safety trial in an animal model. The results of the LEADLESS study, the first human trial to look at safety and feasibility of the leadless device, are discussed and the possible implications for future clinical practice examined. KeywordsLeadless pacemaker, cardiac arrhythmias, pacemak...

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Lead Extraction Is Preferred for Lead Revisions and System Upgrades: When Less Is More

Cited by 106 publications

References 90 publications

Creation of the sole regional laser lead extraction program serving Atlantic Canada: initial experience

Creation of the sole regional laser lead extraction program serving Atlantic Canada: initial experience

Sondenextraktionen eine anspruchsvolle Aufgabe

The Promise of Leadless Pacing: Based on Presentations at Nanostim Sponsored Symposium Held at the European Society of Cardiology Congress 2013, Amsterdam, The Netherlands, 2 September 2013

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