F A L E Bracke1, A Meijer, L M van Gelder. 1. Department of Cardiology, Catharina Hospital, Michelangelolaan 2, P.O. Box 1350, 5602 ZA Eindhoven, The Netherlands. frank.bracke@cze.nl
Abstract
AIMS: We report a single-centre experience of extraction of infected pacing and ICD leads. METHODS: Retrospective study of consecutive lead extractions for infection. Lead extraction was by traction, or, if unsuccessful, a laser sheath was used. All procedures were performed in the operating room. RESULTS: Leads were extracted in 82 patients including 66 patients (80%) with infection occurring after replacement of the generator or revision of the leads. Previous treatment, without lead extraction, had failed in 51 patients (62%). Major complications (tamponade or haemothorax) occurred in 6 patients, 2 patients died despite emergency surgery. One patient succumbed to ongoing sepsis. Of the patients alive, a follow-up of at least 6 months (27 +/- 17 months) was available in 76 patients. All patients were cured; none had a recurrence. In 31 patients (41%) pacing was abandoned after lead extraction; all remained asymptomatic. CONCLUSION: Lead extraction is effective in curing pacemaker or ICD related infection, even after failed conservative therapy, but with a significant complication rate. The routine replacement of the generator should be reconsidered in patients in whom the indication for pacing is no longer valid, as the majority of infections occurred after revision of the system. Copyright 2004 The European Society of Cardiology
AIMS: We report a single-centre experience of extraction of infected pacing and ICD leads. METHODS: Retrospective study of consecutive lead extractions for infection. Lead extraction was by traction, or, if unsuccessful, a laser sheath was used. All procedures were performed in the operating room. RESULTS: Leads were extracted in 82 patients including 66 patients (80%) with infection occurring after replacement of the generator or revision of the leads. Previous treatment, without lead extraction, had failed in 51 patients (62%). Major complications (tamponade or haemothorax) occurred in 6 patients, 2 patients died despite emergency surgery. One patient succumbed to ongoing sepsis. Of the patients alive, a follow-up of at least 6 months (27 +/- 17 months) was available in 76 patients. All patients were cured; none had a recurrence. In 31 patients (41%) pacing was abandoned after lead extraction; all remained asymptomatic. CONCLUSION: Lead extraction is effective in curing pacemaker or ICD related infection, even after failed conservative therapy, but with a significant complication rate. The routine replacement of the generator should be reconsidered in patients in whom the indication for pacing is no longer valid, as the majority of infections occurred after revision of the system. Copyright 2004 The European Society of Cardiology
Authors: Samer Hakmi; Simon Pecha; Björn Sill; Beate Reiter; Stephan Willems; Muhammet Ali Aydin; Yalin Yildirim; Hermann Reichenspurner; Hendrik Treede Journal: Interact Cardiovasc Thorac Surg Date: 2013-09-30
Authors: Michał Chudzik; Andrzej Kutarski; Przemysław Mitkowski; Andrzej Przybylski; Joanna Lewek; Barbara Małecka; Tomasz Smukowski; Aleksander Maciąg; Janusz Smigielski Journal: Arch Med Sci Date: 2013-03-06 Impact factor: 3.318