Should they stay, or should they go: Do we need to remove the old cardiac implantable electronic device if a new system is required on the contralateral side?

Weng, Willy; Thériault-Lauzier, Pascal; Birnie, David H.; Redpath, Calum J.; Golian, Mehrdad; Sadek, Mouhannad M.; Klein, Andres; Ramirez, F. Daniel; Davis, Darryl R.; Nery, Pablo B.; Nair, Girish M.; Hansom, Simon P.; Green, Martin S.; Aydın, Alper

doi:10.1016/j.hroo.2022.02.005

Cited by 2 publications

(1 citation statement)

References 23 publications

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“…Alternatively, programming alternations and abandonment of a device in a non-pacing-dependent patient might be considered. A small cohort study (n = 40) recently reported the safety and feasibility of this approach [43]. Lead extraction to facilitate downgrade procedures, avoid venous crowding and maintain MRI compatibility may be considered in selected cases.…”

Section: Discussionmentioning

confidence: 99%

One-Year Mortality in Patients Undergoing an Implantable Cardioverter Defibrillator or Cardiac Resynchronization Therapy Pulse Generator Replacement: Identifying Patients at Risk

Feijen,

Egorova,

Kuijken

et al. 2023

JCM

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Implantable cardioverter defibrillators (ICDs) significantly contribute to the prevention of sudden cardiac death in selected patients. However, it is essential to identify those who are likely to not have benefit from an ICD and to defer a pulse generator exchange. Easily implementable guidelines for individual risk stratification and decision making are lacking. This study investigates the 1-year mortality of patients who underwent an ICD or cardiac resynchronization therapy with defibrillator function (CRT-D) pulse generator replacement in a contemporary real-world tertiary hospital setting. The cause of death and patient- and procedure-related factors are stratified, and predictive values for 1-year mortality are evaluated. Patients with a follow-up of ≥365 days (or prior mortality) after an ICD or CRT-D exchange at the Leiden University Medical Center from 1 January 2018 until 31 December 2021 were eligible. In total, 588 patients were included (77% male, 69 [60–76] years old, 59% primary prevention, 46% ischemic cardiomyopathy and 37% mildly reduced left ventricular ejection fraction (LVEF)). Patients undergoing a CRT-D replacement or upgrade had a significantly higher 1-year all-cause mortality (10.7% and 11.9%, respectively) compared to patients undergoing ICD (2.8%) exchange (p = 0.002). LVEF ≤ 30%, New York Heart Association class ≥ 3, estimated glomerular filtration rate ≤ 30 mL/min/m2 and haemoglobin ≤ 7 mmol/L were independently associated with mortality within 1 year after pulse generator replacement. There is a growing need for prospectively validated risk scores to weight individualized risk of mortality with the expected ICD therapy benefit and to support a well-informed, shared decision-making process.

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Section: Discussionmentioning

confidence: 99%

One-Year Mortality in Patients Undergoing an Implantable Cardioverter Defibrillator or Cardiac Resynchronization Therapy Pulse Generator Replacement: Identifying Patients at Risk

Feijen,

Egorova,

Kuijken

et al. 2023

JCM

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Device–device interference triggered by an abandoned pacemaker: a case report

Wang,

Mueller-Leisse,

Hillmann

et al. 2024

European Heart Journal - Case Reports

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Background Cardiac implantable electronic devices (CIED) are prone to electromagnetic interference. Common sources include household electronics and industrial machinery. However, medical equipment can also trigger interferences and cause CIED malfunction. Case summary We report on a 79-year-old male with sudden onset of presyncope. He has a long history of device therapy, including an active VVI leadless pacemaker and an abandoned abdominal pacemaker with epicardial leads. Automatic reactivation of the abandoned pacemaker due to reaching end-of-life mode led to interaction with the active pacemaker, inhibiting it in its function. Due to elevated capture threshold and insufficient output, pacing by the reactivated pacemaker was accompanied by intermittent loss of myocardial capture and patient symptoms. By changing the mode to VOO and increasing the pacing rate of the active pacemaker, interaction was prevented as an intermittent solution. Final therapy consisted of explanting the pulse generator of the abdominal pacemaker. Conclusion We present a patient with a deactivated abandoned cardiac pacemaker, which self-activated after reaching end-of-life mode and triggered an interaction with his active pacemaker. This case emphasizes the importance of explanting old devices to avoid potential interaction.

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Should they stay, or should they go: Do we need to remove the old cardiac implantable electronic device if a new system is required on the contralateral side?

Cited by 2 publications

References 23 publications

One-Year Mortality in Patients Undergoing an Implantable Cardioverter Defibrillator or Cardiac Resynchronization Therapy Pulse Generator Replacement: Identifying Patients at Risk

One-Year Mortality in Patients Undergoing an Implantable Cardioverter Defibrillator or Cardiac Resynchronization Therapy Pulse Generator Replacement: Identifying Patients at Risk

Device–device interference triggered by an abandoned pacemaker: a case report

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