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Predictors of lead break during transvenous lead extraction
Junji Morita1, Kyohei Yamaji1, Michio Nagashima1
1Department of Cardiology Kokura Memorial Hospital Kitakyushu Japan.
Lead break during transvenous lead extraction (TLE) is common, especially for older, passive, or non-polyurethane insulated leads. This complication increases procedure time and cardiac tamponade risk.
Area of Science:
- Cardiology
- Medical Device Engineering
Background:
- The incidence, predictors, and clinical impact of lead break during transvenous lead extraction (TLE) were previously unknown.
- Lead fragmentation during TLE can complicate device removal.
Purpose of the Study:
- To identify the incidence, predictors, and clinical impact of lead break during TLE.
Main Methods:
- A retrospective analysis of consecutive patients undergoing TLE between September 2013 and July 2019.
- Lead break defined as lead stretching/misshapen appearance on fluoroscopy during removal.
Main Results:
- 101 out of 501 leads (20.1%) broke during TLE.
- Predictors of lead break included high lead age, passive leads, coradial leads, and non-polyurethane insulation.
- Broken leads were associated with longer procedure times and increased cardiac tamponade rates.
Conclusions:
- Lead age, coradial bipolar leads, passive leads, and leads without polyurethane insulation are significant predictors of lead break during TLE.
- Lead break can increase the difficulty and complications of lead extraction procedures.
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