SORA

Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

Non-Laser Percutaneous Extraction of Pacemaker and Defibrillation Leads: A Decade of Progress

Domenichini, G; Gonna, H; Sharma, R; Conti, S; Fiorista, L; Jones, S; Arthur, M; Adhya, S; Jahangiri, M; Rowland, E; et al. Domenichini, G; Gonna, H; Sharma, R; Conti, S; Fiorista, L; Jones, S; Arthur, M; Adhya, S; Jahangiri, M; Rowland, E; Gallagher, MM (2017) Non-Laser Percutaneous Extraction of Pacemaker and Defibrillation Leads: A Decade of Progress. EUROPACE, 19 (9). pp. 1521-1526. ISSN 1099-5129 https://doi.org/10.1093/europace/euw162
SGUL Authors: Gallagher, Mark Michael

[img] Microsoft Word (.docx) Accepted Version
Available under License ["licenses_description_publisher" not defined].

Download (68kB)

Abstract

Aims Non-laser-based methods are safe in lead extraction but in the past have been less effective than laser methods. In the past decade, new equipment has been introduced including the Evolution® Mechanical Dilator Sheath and the Evolution® RL. We sought to determine the impact of new equipment on outcome in mechanical lead extraction. Methods and results We considered 288 consecutive patients (age 66 ± 18 years) who underwent transvenous lead extraction (TLE) of 522 leads in the decade to the end of 2014. Three groups were identified: Group 1 (pre-Evolution® period, 76 patients, 133 leads), Group 2 (original Evolution® period, 115 patients, 221 leads), and Group 3 (Evolution® RL period, 97 patients, 168 leads). The age of leads was significantly greater in Groups 2 and 3 (6.2 ± 4.4 and 6.1 ± 5.4 years vs.4.7 ± 4.5, P < 0.05) as was the proportion of implantable cardioverter defibrillator leads (27.2 and 28.9 vs. 14.3%, P < 0.05). The groups were similar in the number of leads extracted per patient. Despite the increasing complexity of the systems extracted, complete extraction was achieved in a progressively greater proportion of leads (88.0% in Group 1, 95.5% in Group 2, and 97.6% in Group 3, P < 0.05), and procedure duration was similar. The proportion of leads for which femoral access was required was greater in Group 3 (11%, 18/164) compared with Group 2 (3%, 7/211), P = 0.006. The only major complications were a post-procedure subacute tamponade in Group 1 and an oesophageal injury related to transoesophageal echocardiography in Group 3. Conclusion With current equipment, mechanical extraction provides a good combination of efficacy and safety.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in EP-Europace following peer review. The version of record Gallagher, ; Domenichini, G; Gonna, H; Sharma, R; Conti, S; Fiorista, L; Jones, S; Arthur, M; Adhya, S; Jahangiri, M; et al. (2016) Non-Laser Percutaneous Extraction of Pacemaker and Defibrillation Leads: A Decade of Progress. EP Europace, Volume 19, Issue 9, 1 September 2017, Pages 1521–1526 is available online at: https://doi.org/10.1093/europace/euw162
Keywords: Cardiovascular System & Hematology, 1103 Clinical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Cardiac (INCCCA)
Journal or Publication Title: EUROPACE
ISSN: 1099-5129
Dates:
DateEvent
1 September 2017Published
17 May 2017Published Online
24 March 2016Accepted
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
UNSPECIFIEDEuropean Heart Rhythm AssociationUNSPECIFIED
URI: https://openaccess.sgul.ac.uk/id/eprint/107925
Publisher's version: https://doi.org/10.1093/europace/euw162

Actions (login required)

Edit Item Edit Item