Abstract：
BACKGROUND:The number of lead extractions is growing because of the greater population and increasing age of individuals with a cardiac implantable electronic device. Lead extraction procedures can be complex undertakings with risk of significant mortality, and vascular tears in the superior vena cava are of greatest concern. OBJECTIVE:The purpose of this study was to study whether a novel algorithm that analyzes pre-extraction computed tomographic (CT) images can determine the likelihood and location of lead-lead interactions and lead-vessel attachment within patients' venous vasculatures. This information can be used to identify potential case challenges in the planning stages. METHODS:We developed an algorithm to estimate the presence and position of lead-lead interactions and lead-vessel adherences by tracking distance between the leads and distance between the lead and superior vena cava in a sample of 12 patients referred to the United Heart and Vascular Clinic for lead extractions due to infection (n = 5), lead failure (n = 5), and tricuspid regurgitation (n = 2). RESULTS:Preliminary results indicate that the developed algorithm successfully identified lead-lead and lead-vascular attachments compared to review of CT images by medical experts. CONCLUSION:With future validation and clinical implementation, this algorithm could aid physician preparedness by minimizing intraprocedural emergencies and may improve patient outcomes.
journal_name
Heart Rhythmjournal_title
Heart rhythmauthors
Holm MA,Vatterott PJ,Gaasedelen EN,Syed I,Khan A,Iles TL,Iaizzo PAdoi
10.1016/j.hrthm.2020.01.003subject
Has Abstractpub_date
2020-06-01 00:00:00pages
1009-1016issue
6eissn
1547-5271issn
1556-3871pii
S1547-5271(20)30007-2journal_volume
17pub_type
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