Cardiovascular Implantable Electronic Device Lead Management and Extraction

Publication Date: September 14, 2017

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

...mary focus is on ICD leads due to their...


...ble 1. DefinitionsHaving trouble viewing table?...


Treatment

...reatment

Lead Survival

...odel and clinical scenario-specific str...


...ting CIED Lead Management...

...he lead in a condition that will permit fut...

...eration with the patient on the decision to...

...donment or removal can be a useful treat...


...D Infection...

...s are going to be prescribed, drawing a...

...culture of generator pocket tissue and the explan...

...transesophageal echocardiography is r...

...physicians with specific expertise in CIED i...

...ophageal echocardiography can be useful for pa...

...tion by physicians with specific ex...

...imaging may be considered to facilitate the diagn...

A complete course of antibiotics based on identif...

...ice and lead removal is recommended for...

...e removal of epicardial leads and patches is rec...

...evice and lead removal is recommended f...

...device and lead removal is recommended for pati...

...ful consideration of the implications of other i...


...Factors for CIED InfectionHaving trouble vie...


...ations for Lead Extraction (Noninfe...

Device and/or lead removal can be useful for...

...val is recommended for patients with cl...

...ead removal is recommended for patients with S...

...s recommended for patients with planne...

...al as part of a comprehensive plan for maintaining...

...moval can be useful for patients with i...

...removal is recommended for patients with life-t...

...l can be useful for patients with a CIED loca...

...ead removal can be useful for patients if a CIED...

Lead removal can be useful for patients...

...oval may be considered for patients with leads t...

...l may be considered for patients to...

...oval may be considered in the setting o...


...ocedural Management...

...atory Phase Perform a comprehensive histo...


Outcomes and Fol...

...traction programs and operator-specific i...


...Lead Abandonment Clinical ScenariosHaving troub...


...Factors Associated with Extraction Procedure Comp...


...able 5. Extraction Procedure-Related Complicati...


...igure 1. Management of Suspected CIED Infectio...


...nagement of Suspected Pocket Infection...


...gure 3. Management of Bacteremia without...