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
...Diagnosis
...ary focus is on ICD leads due to their highe...
...nitions Term...
Treatment
...Tre...
...Lead Survival...
...l and clinical scenario-specific s...
...Existing CIED L...
...the lead in a condition that will p...
...areful consideration with the patient...
...ndonment or removal can be a useful treatment s...
...ibiotics are going to be prescribed, drawing a...
...d culture of generator pocket tissue a...
...transesophageal echocardiography i...
Evaluation by physicians with spec...
...eal echocardiography can be useful for pa...
...uation by physicians with specific exper...
Additional imaging may be consider...
...mplete course of antibiotics based on identificati...
...vice and lead removal is recommended for all pati...
...l of epicardial leads and patches is recommended f...
...ice and lead removal is recommended for...
...plete device and lead removal is recommend...
...ration of the implications of other implan...
...le 2. Risk Factors for CIED Infection...
...Indications for...
...nd/or lead removal can be useful for patients with...
Lead removal is recommended for patients with c...
...is recommended for patients with SVC stenosis or...
...ead removal is recommended for patients with...
...removal as part of a comprehensive...
...ead removal can be useful for patients with...
...ad removal is recommended for patien...
Lead removal can be useful for patients with a CIE...
...al can be useful for patients if a CIED impla...
...can be useful for patients with an aband...
Lead removal may be considered for pat...
...may be considered for patients to facilitate acce...
...ay be considered in the setting of...
...Periprocedural Ma...
...e Perform a comprehensive history and physi...
Outco...
...action programs and operator-specific info...
...Abandonment Clinical Scenarios...
...s Associated with Extraction Procedure Complic...
...raction Procedure-Related Complications...
...Management of Suspected CIED Infec...
...2. Management of Suspected Pocket Infec...
...3. Management of Bacteremia without Evide...