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[Percutaneous extraction of pacemaker and defibrillator leads]
Tomasa Centella1, Enrique Oliva, Ignacio García-Andrade
1Servicio de Cirugía Cardiaca de Adultos, Hospital Ramón y Cajal, Madrid, Spain. centellato@telefonica.net
Revista Espanola De Cardiologia
|June 21, 2007
Summary
Percutaneous extraction of pacemaker and defibrillator leads is frequently successful using modern techniques. Specialized centers with surgical backup are recommended due to a low but present risk of complications.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Device Removal
Context:
- Increasing need for removal of endocardial pacing and defibrillator leads.
- Lead extraction procedures can be complex and carry risks.
Purpose:
- To review experience with percutaneous extraction of pacing and defibrillator leads between April 1989 and June 2006.
- To assess the efficacy and safety of lead extraction techniques.
Summary:
- 314 leads were extracted from 187 patients, with a 96.8% complete removal rate.
- Indications included infection, dysfunction, erosion, endocarditis, and bacteremia.
- Countertraction techniques were most common (60.7%), with a 4.6% overall complication rate.
Impact:
- Demonstrates high success rates for lead extraction using contemporary methods.
- Identifies patient factors (age < 60, endocarditis, right-sided implantation) associated with complications.
- Highlights the importance of performing lead extractions in specialized centers with surgical capabilities.
