Low-temperature electrocautery for high-risk cardiac implantable electronic device procedures

With rising numbers of cardiac implantable electronic devices (CIEDs) implanted each year, the population of patients with those devices is growing extensively [1].Large numbers of those patients will eventually require secondary procedures, including device replacements, or upgrades.As during past years , the implanted systems become surrounded by adhesive tissue and fibers, the secondary procedures have been historically associated with a higher risk of short-and long-term complications, most often including lead damage.Moreover, due to comorbidities, a high percentage of patients with CIEDs are treated nowadays with anticoagulants, which increases the risk of bleeding and pocket hematoma.Thus, electrocautery is used to mitigate the risk of periprocedural bleeding.However, the use of conventional electrocautery can risk lead dysfunction due to its thermal injury.The low-temperature electrocautery has been proven to improve local outcomes [2].Few reports were published to date on its utilization in CIED-related procedures [3][4][5].The aim of this analysis was to summarize its safety and efficacy in higher complication-risk procedures performed in a tertiary Polish center.