IR@PKUHSC  > 北京大学第二临床医学院
学科主题临床医学
Implantable defibrillator lead extraction with optimized standard extraction techniques
Chu, Xian-Ming1,2; Li, Xue-Bin1; Zhang, Ping1; An, Yi2; Duan, Jiang-Bo1; Wang, Long1; Li, Ding1; Li, Bing3; Guo, Ji-Hong1
关键词Lead Extraction Implantable cardioverter-defibrillator Infection Complications
刊名JOURNAL OF GERIATRIC CARDIOLOGY
2013
DOI10.3724/SP.J.1263.2012.08211
10期:1页:3-9
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Cardiac & Cardiovascular Systems ; Geriatrics & Gerontology
研究领域[WOS]Cardiovascular System & Cardiology ; Geriatrics & Gerontology
关键词[WOS]ELECTRONIC DEVICE INFECTIONS ; PACEMAKER ; MANAGEMENT ; DIAGNOSIS ; MORTALITY ; REMOVAL ; SYSTEMS
英文摘要

Background Implantable cardioverter-defibrillator (ICD) leads might not be extracted especially in developing countries because of the high cost and lack of specialized tools. We aimed to evaluate transvenous extraction of ICD leads using optimized standard techniques. Methods We prospectively analyzed clinical characteristics, optimized extraction techniques and the feasibility of extraction for 40 patients (33 males; mean age 47.9 +/- 16.1 years) with 42 ICD leads. Results Complete procedural success rate was 95.2% (40/42), and the clinical success rate was 97.6% (41/42). One ICD lead required cardiothoracic surgery. Minor complications occurred in three cases (7.5%), and no major complications or death occurred. Locking stylets were used to extract most leads (34, 81.0%) and almost half of the leads (20, 47.6%) required mechanical dilatation to free fibrotic adhesions; these leads had been implanted for a longer period of time than the others (43.7 +/- 18.2 vs. 18.4 +/- 13.4 months, P < 0.05). Three-quarters of the leads (30, 71.4%) were extracted with locking stylets plus manual traction (12, 28.6%), or mechanical dilatation with counter-traction (18, 42.8%) by the superior vena cava approach and one-quarter of the leads (11, 26.2%) were removed by optimized snare techniques using the femoral vein approach. Median extraction time was 20 min (range 2-68 min) per lead. Linear regression analysis showed that the extraction time was significantly correlated with implant duration (r = 0.70, P < 0.001). Median follow-up was 14.5 months (range 1-58 months), no infection, or procedure-related death occurred in our series. Conclusions Our optimized procedure for transvenous extraction of ICD leads provides a practical and low-cost method for standard procedures. J Geriatr Cardiol 2013; 10: 3-9. doi: 10.3724/SP.J.1263.2012.08211

语种英语
WOS记录号WOS:000316871000001
项目编号81001346 ; 81071246 ; 2012YD18035 ; Z121107001012016
资助机构National Natural Science Foundation of China ; Shandong Project ; Capital Project
引用统计
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/59555
专题北京大学第二临床医学院
北京大学临床肿瘤学院_药剂科
北京大学精神卫生研究所_计算机室
作者单位1.Peking Univ, Peoples Hosp, Dept Cardiac Electrophysiol, Beijing 100044, Peoples R China
2.Qingdao Univ, Coll Med, Affiliated Hosp, Dept Cardiol, Qingdao 266100, Peoples R China
3.Qingdao Univ, Coll Med, Dept Biol, Qingdao 266021, Peoples R China
推荐引用方式
GB/T 7714
Chu, Xian-Ming,Li, Xue-Bin,Zhang, Ping,et al. Implantable defibrillator lead extraction with optimized standard extraction techniques[J]. JOURNAL OF GERIATRIC CARDIOLOGY,2013,10(1):3-9.
APA Chu, Xian-Ming.,Li, Xue-Bin.,Zhang, Ping.,An, Yi.,Duan, Jiang-Bo.,...&Guo, Ji-Hong.(2013).Implantable defibrillator lead extraction with optimized standard extraction techniques.JOURNAL OF GERIATRIC CARDIOLOGY,10(1),3-9.
MLA Chu, Xian-Ming,et al."Implantable defibrillator lead extraction with optimized standard extraction techniques".JOURNAL OF GERIATRIC CARDIOLOGY 10.1(2013):3-9.
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