title: Management of malfunctioning and recalled pacemaker and defibrillator leads: results of the European Heart Rhythm Association survey.
abstract: The aim of this survey was to describe the different strategies regarding the management of malfunctioning and recalled pacemaker and defibrillator leads across Europe. A questionnaire has been designed to assess the current practice and physician's approach to the management of leads which are faulty, unnecessary, and/or recalled. Responses to the questionnaire were received from 34 hospitals-members of the European Heart Rhythm Association (EHRA) electrophysiology (EP) research network. The survey involved both very high and low volume implanting centres, with 85% of the responding centres performing lead extraction. The survey provides a panoramic view of operator's decision making in the field of malfunctioning, recalled, and redundant leads and outlines a common point of view on lead abandonment and factors influencing the decision about lead extraction. The main factors strongly influencing the decision making were patient's age (59%), the presence of the damaged leads (44%), and the lead dwelling time (44%). Regarding the lead abandonment, the main concern (61%) was the potential greater difficulty associated with lead extraction in the future. High volume extracting centres showed a greater propensity to removing the malfunctioning or recalled leads compared with low volume or non-extracting centres. This EP Wire survey gives a snapshot of the operators' approaches and options regarding redundant, malfunctioning, and recalled lead management and may form the basis for future prospective research on this topic.
authors.affiliation: CardioThoracic and Vascular Department University Hospital-Pisa, Italy m.g.bongiorni@med.unipi.it.
authors.forename: Maria
authors.initials: M
authors.lastname: Grazia Bongiorni
authors.affiliation: Second Cardiology Department, Attikon University Hospital, University of Athens, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Dagres
authors.affiliation: Department of Cardiology Medizinische Klinik und Poliklinik I, LMU Klinikum der Universität München, Munich, Germany.
authors.forename: Heidi
authors.initials: H
authors.lastname: Estner
authors.affiliation: Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Laurent
authors.initials: L
authors.lastname: Pison
authors.affiliation: Institute of Cardiovascular Medicine and Science Liverpool Heart & Chest Hospital, Liverpool, UK.
authors.forename: Derick
authors.initials: D
authors.lastname: Todd
authors.affiliation: Department of Cardiology, Institution of Medical Science, Uppsala University, Uppsala, Sweden.
authors.forename: Carina
authors.initials: C
authors.lastname: Blomstrom-Lundqvist
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002304:Cardiac Pacing, Artificial; D017147:Defibrillators, Implantable; D020878:Device Removal / Q000009:adverse effects; D004554:Electric Countershock / Q000009:adverse effects*; D005060:Europe; D019538:Health Care Surveys; D061847:Hospitals, High-Volume; D061846:Hospitals, Low-Volume; D006801:Humans; D057052:Medical Device Recalls; D008875:Middle Aged; D010138:Pacemaker, Artificial; D018579:Patient Selection; D010818:Practice Patterns, Physicians'; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Abandonment; Cardiac implantable electronic devices; EHRA survey; EP wire; Extraction; Implantable Cardioverter-defibrillator; Leads; Malfunction; Pacemaker; Recall