Cardiovascular Implantable Electronic Device Lead Management and Extraction
Key Points
Key Points
- Over the past 60 years, CIEDs have become established as an important therapeutic modality of cardiovascular care for the treatment of patients with bradycardia, tachycardia, and heart failure.
- Although recent technological advances have eliminated the need for transvenous or epicardial leads for CIEDs used in selected groups of patients, lead management remains critical for a variety of reasons.
- Recent estimates suggest that 1.2–1.4 million CIEDs are implanted annually worldwide.
- Questions on lead management arise in a number of situations, including when changes in a patient’s clinical condition make a different functionality more or less important, if a lead becomes nonfunctional, and if the presence of a lead is thought to interfere with the patients' optimal treatment.
Diagnosis
...agnosis...
...rimary focus is on ICD leads due to their h...
...1. DefinitionsHaving trouble viewing table?...
Treatment
...eatmen...
...ad Surviva...
...ead model and clinical scenario-specific strate...
...CIED Lead Management...
...ving the lead in a condition that will permi...
...reful consideration with the patient on the...
...ad abandonment or removal can be a useful treat...
...Infection...
...ics are going to be prescribed, drawing at leas...
...culture of generator pocket tissue an...
Preprocedural transesophageal echocar...
Evaluation by physicians with specif...
...geal echocardiography can be useful for patients w...
...hysicians with specific expertise in CIE...
...itional imaging may be considered to facilitat...
A complete course of antibiotics based on...
...and lead removal is recommended for all patient...
...oval of epicardial leads and patches...
...and lead removal is recommended for...
...vice and lead removal is recommended for patien...
...deration of the implications of other implanted...
...Factors for CIED InfectionHaving t...
...dications for Lead Extraction (Noninfectious)...
...ce and/or lead removal can be useful for p...
...is recommended for patients with clinically...
...recommended for patients with SVC st...
...d removal is recommended for patients with plann...
Lead removal as part of a comprehensive...
...be useful for patients with ipsilateral venous o...
...emoval is recommended for patients with life-thr...
...can be useful for patients with a CIED location...
...val can be useful for patients if a CIED implant...
...an be useful for patients with an aband...
...removal may be considered for patients w...
...d removal may be considered for patients...
...y be considered in the setting of norma...
...cedural Management...
...ratory Phase Perform a comprehensive his...
...utcomes and Follow-up
...programs and operator-specific information on...
...d Abandonment Clinical ScenariosHaving trouble v...
.... Factors Associated with Extraction Procedure...
...xtraction Procedure-Related ComplicationsHa...
.... Management of Suspected CIED Infec...
...gure 2. Management of Suspected Pocket Infectio...
...agement of Bacteremia without Evidence...