Journal article
Non-laser percutaneous extraction of pacemaker and defibrillation leads: a decade of progress
Europace (London, England), Vol.19(9), pp.1521-1526
09/01/2017
DOI: 10.1093/europace/euw162
PMID: 28340095
Abstract
Non-laser-based methods are safe in lead extraction but in the past have been less effective than laser methods. In the past decade, new equipment has been introduced including the Evolution® Mechanical Dilator Sheath and the Evolution® RL. We sought to determine the impact of new equipment on outcome in mechanical lead extraction.
We considered 288 consecutive patients (age 66 ± 18 years) who underwent transvenous lead extraction (TLE) of 522 leads in the decade to the end of 2014. Three groups were identified: Group 1 (pre-Evolution® period, 76 patients, 133 leads), Group 2 (original Evolution® period, 115 patients, 221 leads), and Group 3 (Evolution® RL period, 97 patients, 168 leads). The age of leads was significantly greater in Groups 2 and 3 (6.2 ± 4.4 and 6.1 ± 5.4 years vs.4.7 ± 4.5, P < 0.05) as was the proportion of implantable cardioverter defibrillator leads (27.2 and 28.9 vs. 14.3%, P < 0.05). The groups were similar in the number of leads extracted per patient. Despite the increasing complexity of the systems extracted, complete extraction was achieved in a progressively greater proportion of leads (88.0% in Group 1, 95.5% in Group 2, and 97.6% in Group 3, P < 0.05), and procedure duration was similar. The proportion of leads for which femoral access was required was greater in Group 3 (11%, 18/164) compared with Group 2 (3%, 7/211), P = 0.006. The only major complications were a post-procedure subacute tamponade in Group 1 and an oesophageal injury related to transoesophageal echocardiography in Group 3.
With current equipment, mechanical extraction provides a good combination of efficacy and safety.
Details
- Title: Subtitle
- Non-laser percutaneous extraction of pacemaker and defibrillation leads: a decade of progress
- Creators
- Giulia Domenichini - St George’s University Hospitals NHS Foundation TrustHanney Gonna - St George’s University Hospitals NHS Foundation TrustRajan Sharma - St George’s University Hospitals NHS Foundation TrustSergio Conti - St George’s University Hospitals NHS Foundation TrustLorenzo Fiorista - St George’s University Hospitals NHS Foundation TrustSue Jones - St George’s University Hospitals NHS Foundation TrustMaria Arthur - St George’s University Hospitals NHS Foundation TrustShaumik Adhya - St George’s University Hospitals NHS Foundation TrustMarjan Jahangiri - Department of Cardiac Surgery, St. George's Hospital, London SW17 0QT, UKEdward Rowland - St George’s University Hospitals NHS Foundation TrustMark M Gallagher - St George’s University Hospitals NHS Foundation Trust
- Resource Type
- Journal article
- Publication Details
- Europace (London, England), Vol.19(9), pp.1521-1526
- DOI
- 10.1093/europace/euw162
- PMID
- 28340095
- ISSN
- 1099-5129
- eISSN
- 1532-2092
- Language
- English
- Date published
- 09/01/2017
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984822978302771
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