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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
PubMed
Summary
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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.

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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.