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
...gnosis...
...y focus is on ICD leads due to their higher fa...
...nitionsHaving trouble viewing table? Expand...
Treatment
...reatme...
...Survival...
A lead model and clinical scenario-speci...
...xisting CIED Lead Mana...
...the lead in a condition that will permi...
...areful consideration with the patient on th...
...or removal can be a useful treatm...
CIED Infecti...
If antibiotics are going to be pre...
Gram stain and culture of generator poc...
...procedural transesophageal echocardiography i...
...y physicians with specific expertise in CIE...
...geal echocardiography can be useful...
...aluation by physicians with specific expertise in...
...onal imaging may be considered to facilitate t...
...omplete course of antibiotics based on id...
...te device and lead removal is recommended for al...
...moval of epicardial leads and patches is...
...and lead removal is recommended for all p...
Complete device and lead removal is recommended fo...
Careful consideration of the implications of ot...
...2. Risk Factors for CIED InfectionHaving trouble...
...for Lead Extraction (Noninfectious)...
...vice and/or lead removal can be useful for...
...ead removal is recommended for patients with cl...
...recommended for patients with SVC stenosis o...
...al is recommended for patients with pla...
...val as part of a comprehensive plan for maint...
...removal can be useful for patients with i...
...s recommended for patients with life-thr...
...removal can be useful for patients with a...
...removal can be useful for patient...
...be useful for patients with an abandone...
...removal may be considered for patients with lead...
...emoval may be considered for patients to facil...
...val may be considered in the setting...
...procedural Management...
...ory Phase Perform a comprehensive history a...
...omes and Follow-up
...raction programs and operator-specific informati...
...ad Abandonment Clinical ScenariosHaving tr...
...rs Associated with Extraction Procedu...
...5. Extraction Procedure-Related Compl...
...ement of Suspected CIED Infection...
...e 2. Management of Suspected Pocke...
...ment of Bacteremia without Evidence...