Single-operator experience with a mechanical approach for removal of pacing and implantable defibrillator leads.
OBJECTIVE
Recently, a mechanical single-sheath technique with a multiple venous entry-site approach for the removal of pacemaker and implantable defibrillator leads was reported to have a high success rate and few complications. In our institution, this technique of lead removal has been used since 2002. In this paper, we report our experience, with the aim of evaluating the effectiveness and safety of the proposed procedure.


RESULTS
This study is a retrospective analysis of the case records of all patients referred to our institution for transvenous lead extraction, according to class I or II Heart Rhythm Society indications. Over 7 years, 300 consecutive patients underwent procedures for transvenous removal of 518 leads. The most frequent indication for extraction was infection (74%). Complete removal of 502 (96.9%) leads and partial removal of 10 leads (1.9%) were achieved. Six leads (1.2%) could not be removed. All defibrillation coils and coronary sinus leads were successfully removed. There were no procedure-related deaths but only one major complication (0.3%).


CONCLUSIONS
Our experience shows that the proposed mechanical technique is very effective and associated with few serious complications, thus confirming previous findings. This approach may be reproduced in other settings with very satisfactory results.
Calvagna
Giuseppe M
GM
Division of Cardiology, San Vincenzo Hospital, Contrada Sirina, Taormina, 38068 Messina, Italy. gicalvagna@tiscali.it
Evola
Rosario
R
Scardace
Giuseppe
G
Valsecchi
Sergio
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017147:Defibrillators, Implantable; D020878:Device Removal / Q000295:instrumentation* / Q000379:methods*; D004567:Electrodes, Implanted; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012189:Retrospective Studies; D016896:Treatment Outcome