Key result
EV-ICD lead is safely extracted with simple traction after 49 months of dwell time.
Why the study?
The EV-ICD lead is implanted in the substernal space, which makes extraction a cautious procedure.
Case Report (n=1)
This case demonstrates that extravascular ICD extraction can be performed safely up to 4 years post-implantation using simple traction, provided that local xiphoid adhesions are carefully dissected first.
Successful simple traction extraction of EV-ICD leads at 49 months appears feasible; leaves open generalizability and safety at longer dwell times.
The extravascular implantable cardioverter-defibrillator (EV-ICD) was developed to overcome complications associated with transvenous leads while being able to deliver anti-tachycardia pacing (ATP). The lead is implanted in the substernal space, which makes extraction a cautious procedure. We present a case of a 51-year-old women with a successful EV-ICD extraction after a lead dwell time of 4 years, which is the longest reported. The EV-ICD lead was extracted using simple traction after the removal of all adhesions at the xiphoidal site around the lead. We advise to only use extraction tools if the initial attempt is not successful and if no adhesions at the caudal part of the lead are visible anymore, as these tools could also damage the surrounding tissue and the lead.
No takes yet. Share an insight, caveat, or question.
Veld et al. (2024) conducted a case report in Indication for extravascular implantable cardioverter-defibrillator extraction (n=1). Extravascular implantable cardioverter-defibrillator extraction was evaluated on Successful EV-ICD lead extraction. An extravascular implantable cardioverter-defibrillator lead was successfully and safely extracted without complications using simple traction after a dwell time of 49 months.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: