Removal of electrodes of implanted systems. The state of the problem

Sapelnikov, O.V.; Kulikov, Alexander A.; Cherkashin, D. I.; Grishin, Ilja; Николаева, О. А.; Ardus, D. F.; Shiryaev, А. A.; Акчурин, Р. С.

doi:10.21688/1681-3472-2019-4-47-52

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…The latest expert consensus statement on CIED lead management has mentioned that whether to abandon or remove those non-infected leads should be decided according to the clinical goal that balances both the risk of a lead removal and abandonment [ 12 – 15 ]. Abandoned leads are highly associated with several risks of complications, such as infections, arrhythmias, vascular trouble, tricuspid valve damage, and thromboembolism [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

The Use of Transvenous Lead Extraction of Non-Infected Leads to Prevent Long-Term Lead-Related Complications

Айвазян¹,

Гамзаев²,

Palagina³

et al. 2021

Sovrem Tehnol Med

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The aim of the investigation was to study the issue of making challenging decisions concerning abandonment or removal of non-infected superfluous leads during lead revisions or cardiac implantable electronic device upgrades. Materials and Methods. From 2010 to 2019, a total of 482 patients who had undergone cardiac implantable electronic device implantation in the past were admitted to hospital for generator replacement or lead revision. In 126 patients, 155 malfunctioning leads were found. Mean age of the patients was 59.2±16.7. Total venous occlusion was found in 10 cases of these patients. All patients were divided into two groups: extracted leads group (n=83) and abandoned leads group (n=43). The main factor which influenced our strategy was the mean age of the lead. In group 1 the mean age of the lead was 6.9±5.6 years. In group 2 it was about 12 years. Results. Lead extraction was performed by manual traction in 69 (61.7%) leads, by lead locking device in 32 (28.5%) leads, and 11 (9.8%) leads were removed using TightRail rotating dilator sheath. In 1 case of total occlusion of the superior vena cava, we performed a video-assisted thoracoscopic lead extraction at the time of vein occlusion recanalisation and electronic device reimplantation. In abandoned leads group 3 patients had lead-related complications. Conclusion. Transvenous lead extraction with the mean age of the lead less than 10 years is an effective and safe strategy. Preventive transvenous lead extraction of non-infected leads allows avoiding lead-related complications in the long-term period.

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Section: Introductionmentioning

confidence: 99%

The Use of Transvenous Lead Extraction of Non-Infected Leads to Prevent Long-Term Lead-Related Complications

Айвазян¹,

Гамзаев²,

Palagina³

et al. 2021

Sovrem Tehnol Med

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Implantation of cardiac contractility modulation device. (Analysis of complications in a 24-month follow-up)

Amanatova¹,

Safiullina²,

Uskach³

et al. 2023

Kardio. vestn.

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Prevention of Pacemaker Malfunctions in Patients With Bradyarrhythmia: Results of a Single-Center Follow-up

Kadyraliev,

Faybushevich,

Maximkin

2023

Innovacionnaâ medicina Kubani

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Objective: To evaluate results of surgical treatment in patients with bradyarrhythmia and risk factors for pacemaker (PM) malfunctions using improved preventive measures.Materials and methods: Our study consisted of two stages. At stage I, we retrospectively analyzed histories and outpatient medical records of 948 patients with various forms of bradiarrhythmias who underwent surgery in the clinic between 2006 and 2021 to identify PM malfunctions that occurred both in the early and late postoperative periods. Based on the data on the most common types of PM malfunctions and possible risk factors for their development, preventive measures were improved in this cohort of patients and were further used at stage II (pilot) to select patients for surgery.During stage II (pilot), 188 patients were operated on between 2019 and 2021: risk factors for malfunctions were identified in 72 (38.3%) cases at the preoperative stage. All the patients underwent surgery with the proposed and improved preventive measures. Followup was during the hospital stay and in 6 and 12 months.Results: At stage I (retrospective analysis), 78 (8.23%) patients had signs of PM malfunction. The most common malfunctions were endocardial electrode displacement (30.8%), increased stimulation threshold (25.6%), a change in the endocardial electrode impedance (17.9%), and impaired sensitivity (10.3%). In addition, premature battery depletion and PM syndrome were present in 9% and 6.4% of the patients, respectively.The correlation analysis revealed that the most common findings associated with malfunctions were enlarged right chambers of the heart due to valvular defects and dilated cardiomyopathy, myocardial remodeling caused by chemotherapy and radiation therapy, postinfarction cardiosclerosis in the electrode implantation area, untimely and inadequate PM programming, as well as increased levels of blood uric acid, urea, and creatinine, and prolonged and uncontrolled use of steroid drugs and bronchodilators.At stage II, there were no PM malfunctions requiring changes in the pacing parameters during the hospitalization period. Six months postsurgery, 1 (1.4%) patient had an increase in impedance (to 2843 ohms) caused by the uncontrolled intake of high doses of corticosteroids due to decompensation of chronic obstructive pulmonary disease. After correction of the corticosteroids dose, the ventricular electrode impedance returned to the normal level. Twelve months postsurgery, 2 (2.8%) patients had a decrease in impedance to 215 and 143 ohms, respectively, caused by the ventricular electrode displacement. After correcting the electrode position, normal pacing parameters were restored. No cardiac complications due to malfunctions were observed. Morphofunctional parameters of the heart did not significantly differ when compared with preoperative ones.Conclusions: Surgical treatment of patients with bradyarrhythmia and risk factors for PM malfunctions who underwent surgery with the proposed preventive measures demonstrated high efficiency in reducing the number of malfunctions and cardiac complications associated with inadequate stimulation in the longterm followup.

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Removal of electrodes of implanted systems. The state of the problem

Cited by 3 publications

References 22 publications

The Use of Transvenous Lead Extraction of Non-Infected Leads to Prevent Long-Term Lead-Related Complications

The Use of Transvenous Lead Extraction of Non-Infected Leads to Prevent Long-Term Lead-Related Complications

Implantation of cardiac contractility modulation device. (Analysis of complications in a 24-month follow-up)

Prevention of Pacemaker Malfunctions in Patients With Bradyarrhythmia: Results of a Single-Center Follow-up

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