Cardiac venous left ventricular lead removal and reimplantation following device infection: A large single-center experience

John Rickard, Khaldoun Tarakji, Edmond Cronin, Michael P. Brunner, Gregory Jackson, Bryan Baranowski, Peter P. Borek, David O. Martin, Oussama Wazni, Bruce L. Wilkoff

Research output: Contribution to journalArticlepeer-review

Abstract

LV Lead Extraction and Reimplantation. Background: Early series of biventricular device removal have contained mostly younger cardiac venous (CV) left ventricular leads and few have reported on rates of successful reimplantation. Methods and Results: We performed a retrospective analysis of all patients referred to the Cleveland Clinic between February 2, 2001 and July 27, 2011 for removal of a biventricular device with a CV pacing lead for an infectious indication. A total of 173 patients were included. The median age of the CV leads was 22.3 months (interquartile range: 5.2-46.3 months). The complete procedural success rate for all leads was 97.7%, with the remaining 2.3% clinical successes. A total of 76.9% of CV leads were removed using simple traction alone with the remaining leads requiring the use of a laser-powered sheath. A total of 3.5% of leads required intervention (manual dissection or laser-powered dissection) within the coronary sinus (CS). Major complications occurred in 1.2% of patients. Minor complications occurred in 7.5% of patients, the majority of which were hematomas requiring drainage (6.9%). CV lead reimplantation was attempted in 107 patients of which 88 (82.8%) were successful. Conclusion: CV lead removal in patients with an infected biventricular device is associated with an extremely high procedural success rate and a low incidence of major complications. The use of a laser-powered sheath is necessary in roughly one-quarter of cases with a very small percentage requiring intervention within the CS. Reimplantation of CV leads is achievable in roughly 83% of patients, a figure lower than nationally quoted estimates for de novo implantations. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1213-1216, November 2012)

Original languageEnglish (US)
Pages (from-to)1213-1216
Number of pages4
JournalJournal of cardiovascular electrophysiology
Volume23
Issue number11
DOIs
StatePublished - Nov 2012

Keywords

  • LV lead
  • cardiac resynchronization therapy
  • device-related infection
  • heart failure
  • laser-powered sheath
  • lead removal

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint Dive into the research topics of 'Cardiac venous left ventricular lead removal and reimplantation following device infection: A large single-center experience'. Together they form a unique fingerprint.

Cite this