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Coronary sinus lead extraction
G Frank O Tyers1, Jacquie Clark, Yan Wang
1Vancouver General Hospital Pacemaker Clinic, Division of Cardiovascular Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada.
Pacing and Clinical Electrophysiology : PACE
|April 12, 2003
Summary
Coronary sinus lead extraction (CS-LE) is complex but safe and effective. This study shows complete removal of CS leads with no serious complications, even for leads in place for many years.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Coronary sinus (CS) leads are associated with higher complication rates during implantation and extraction compared to other lead types.
- Extraction of CS leads poses increased risks, necessitating evaluation of safety and efficacy.
Purpose of the Study:
- To review the experience with non-thoracotomy lead extraction (LE) of coronary sinus leads.
- To evaluate the prevalence, safety, and efficacy of CS lead extraction.
Main Methods:
- Review of a detailed database of lead extractions performed since 1981.
- Analysis of 14 patients referred for CS-LE, including leads intentionally and inadvertently placed.
- Utilized various extraction techniques, from simple traction to advanced methods like intraluminal locking stylets and powered sheaths.
Main Results:
- Complete removal of all CS leads was achieved in all patients.
- CS-LE procedures were performed efficiently, with a mean duration of 13 minutes (1.8 minutes fluoroscopy).
- No serious complications occurred during the procedures, and the mean hospital stay was 4 days.
Conclusions:
- Non-thoracotomy lead extraction of coronary sinus leads is a safe and effective procedure.
- Successful complete lead removal can be achieved regardless of lead placement duration, from months to over 27 years.
- The findings support CS-LE as a viable option for managing CS leads when removal is indicated.