Percutaneous Pacemaker Lead‐Transsecting Catheter

Abstract

We describe the development and successful use of a percutaneous lead-transsection catheter. It was used in two patients in whom removal of chronically implanted atrial pacing leads could not be accomplished by traction.

Permanent Transvenous Pacemaker Implantation in Forty Dogs

“…Removal of the pulse generator is simple and is also recommended in all cases of inf e~t i o n .~~-~I If the lead is not tightly adhered to the right ventricular endocardium, it should also be remOVed.30-33,37-41 Wh en the infection is limited to the pulse generator pocket, a tightly adhered lead may be cut off below the infected area, sealed, and left in pla~e.~'.~' If the infection involves the intravascular portion of the lead, removal of the lead by continuous traction or by thoracotomy and excision from the right ventricle is rec~m m e n d e d .~~,~' ,~~,~~ Vigorous attempts to extract a tightly adhered lead may result in serious arrhythmias, damage to the tricuspid valve, inversion of the right ventricle, and death.45-46 A less traumatic method for severing and removing the intravascular portion of endocardial leads has recently been described. 44 Two dogs with well-positioned endocardial leads experienced loss of pacing in spite of normally functioning pulse generators. Although the leads were not rigorously tested for electrical integrity, both leads appeared to be intact and undamaged.…”

Percutaneous Removal of Infected Permanent Pacemaker Leads Using a Simple Coaxial Dilating System

“…17 REMOVAL OF INFECTED LEADS The 12 French and 14 French biliary dilator sheaths. The14 French sheath has been cut so that its length is 5 cm longer than the distance from the point of entry into the subclavian vein to the proximal superior vena cava.…”