Outcomes of transvenous lead extraction in patients with lead perforation: A single-center experience.

Abstract:

BACKGROUND:Management of cardiac perforation caused by the lead of a cardiac implantable electronic device (CIED) is currently unclear. This study evaluated the outcomes of transvenous lead extraction (TLE) in patients with cardiac perforation caused by a transvenous lead. HYPOTHESIS:Removal of perforated lead by transvenous approach is safe and effective. METHODS:The medical records of all patients diagnosed with cardiac perforation by a pacing or defibrillator lead in Peking University People's Hospital from January 2008 to January 2019 were reviewed. We included patients who were managed by TLE. RESULTS:A total of 53 patients (30 men; mean age: 67 ± 15 years) with lead perforation managed by TLE were included. Most of the perforated leads (94.9%) were pacemaker leads. Forty-three leads (81.1%) were implanted within 1 year. Ten patients with a high risk of hemopericardium underwent percutaneous subxiphoid pericardial puncture prior to TLE. All 53 culprit leads were removed completely without major complications. Simple traction with or without a locking stylet was sufficient in 51 patients (96.2%). Forty-eight patients (90.6%) had a new active-fixation lead reimplanted. No patients showed evidence of new-onset or worsening pericardial effusion during the procedure and hospital stay. During a median follow-up time of 16 months, no recurrence of symptoms associated with lead perforation or CIED-related infection were reported. CONCLUSION:In most patients with lead perforation, TLE can be a safe and effective management approach.

journal_name

Clin Cardiol

journal_title

Clinical cardiology

authors

Zhou X,Ze F,Li D,Wang L,Guo J,Li X

doi

10.1002/clc.23327

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

386-393

issue

4

eissn

0160-9289

issn

1932-8737

journal_volume

43

pub_type

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