Hands on: How to approach patients undergoing lead extraction.

Abstract:

:Due to the growing number of patients treated with cardiac implantable electronic devices (CIEDs) there is an increased need for lead management, evaluation, and extraction. While CIED lead extraction has many indications, a consistent approach to preprocedural planning should be applied in all cases, including a thorough consultation with careful review of the patient's medical and device history, as well as a discussion of informed consent and shared decision-making with the patient and their loved ones. The use of chest X-ray, echocardiography, and computed tomography (CT) scan can further help with risk stratification and procedural planning. Intraprocedural echocardiography (transesophageal or intracardiac) is recommended and allows early recognition of cardiothoracic injury. Establishing an extraction team with cardiology/electrophysiology, anesthesiology, and CT surgery is is crucial to a successful and safe CIED extraction practice, including immediately available surgical backup. This hands-on review will address how to approach patients who are undergoing lead extraction, as well as several innovations in preprocedure and intraprocedural risk assessment.

authors

Lewis RK,Pokorney SD,Hegland DD,Piccini JP

doi

10.1111/jce.14244

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

1801-1808

issue

7

eissn

1045-3873

issn

1540-8167

journal_volume

31

pub_type

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