Advertisement

Lead extraction

  • Charles J. Love
    Correspondence
    Address reprint requests and correspondence: Dr. Charles J. Love, Department of Cardiology, Ohio State University, 1654 Upham Drive, Columbus, Ohio 43210-1228.
    Affiliations
    Division of Cardiology, The Ohio State University, Columbus, Ohio
    Search for articles by this author
      Lead extraction has grown from a “niche” procedure practiced by a select few individuals to a fairly widely disseminated technique. With the apparent increase in device infections, occluded veins and the need for device “upgrades,” more physicians are attempting to extract chronically implanted pacing and implantable cardioverter-defibrillator (ICD) leads. Unfortunately, obtaining training for this procedure is difficult outside of a training program at a center with a physician experienced in lead extraction. Of interest, in the field of interventional cardiology, 1 year of training is necessary, yet for lead extraction, the “see one, do one” approach is accepted. Given the range of tools, techniques, and situations that present themselves, such a casual approach to a complex technique can hardly be endorsed. Indeed, the medicolegal consequences of this cavalier approach have proved to be substantial. This review aims to serve as a starting point, a guide, and an enhancement to the physician’s experience. It is by no means meant to be a comprehensive manual for the physician to read and then go buy some tools and “have at it.” Lead extraction can be a straightforward, uncomplicated procedure, or it can degenerate into a life-threatening (or life-ending) situation in moments.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Heart Rhythm
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Love C.J.
        • Wilkoff B.W.
        • Byrd C.L.
        Recommendations for extraction of chronically implanted transvenous pacing and defibrillator leads: indications, facilities, training.
        Pacing Clin Electrophysiol. 2000; 23;: 544-551
        • Love C.J.
        Current concepts in extraction of transvenous pacing and ICD leads.
        Cardiol Clin. 2000; 18: 193-217
        • Byrd C.L.
        Techniques and devices for lead extraction.
        in: Ellenbogen K.A. Kay N.G. Lau C.P. Wilkoff B.W. Clinical Cardiac Pacing, Defibrillation and Resynchronization Therapy. Elsevier, Philadelphia2006 (Chapter 21)
        • Love C.J.
        Extraction of pacing and defibrillator leads.
        in: Barold S.S. Mugica J.M. The Fifth Decade of Cardiac Pacing. Futura/Blackwell, Boston2004 (Chapter 5)
        • Love C.J.
        • Smith M.C.
        Extraction of pacing leads: overview of current techniques.
        J Cardiovasc Electrophysiol. 2006; 17: 1-5

      Linked Article

      • Erratum
        Heart RhythmVol. 5Issue 1
        • Preview
          In the article, “Lead Extraction” in the September issue of the Journal (4:1238–1243), there was an error. The cost of the Spectranetics Excimer Laser was noted to be in the range of $350,000. The actual cost of the Laser is $244,000. The authors regret the error.
        • Full-Text
        • PDF