Transvenous lead extraction safely removed perforated leads in 100% of patients (53/53) without major complications or new pericardial effusion over a median 16-month follow-up.
Observational (n=53)
No
Is transvenous lead extraction safe and effective for managing patients with cardiac perforation caused by a transvenous CIED lead?
Transvenous lead extraction is a safe and highly effective approach for managing cardiac perforation caused by CIED leads, avoiding the need for open surgical extraction in most cases.
BACKGROUND: Management of cardiac perforation caused by the lead of a cardiac implantable electronic device (CIED) is currently unclear. This study evaluated the outcomes of transvenous lead extraction (TLE) in patients with cardiac perforation caused by a transvenous lead. HYPOTHESIS: Removal of perforated lead by transvenous approach is safe and effective. METHODS: The medical records of all patients diagnosed with cardiac perforation by a pacing or defibrillator lead in Peking University People's Hospital from January 2008 to January 2019 were reviewed. We included patients who were managed by TLE. RESULTS: A total of 53 patients (30 men; mean age: 67 ± 15 years) with lead perforation managed by TLE were included. Most of the perforated leads (94.9%) were pacemaker leads. Forty-three leads (81.1%) were implanted within 1 year. Ten patients with a high risk of hemopericardium underwent percutaneous subxiphoid pericardial puncture prior to TLE. All 53 culprit leads were removed completely without major complications. Simple traction with or without a locking stylet was sufficient in 51 patients (96.2%). Forty-eight patients (90.6%) had a new active-fixation lead reimplanted. No patients showed evidence of new-onset or worsening pericardial effusion during the procedure and hospital stay. During a median follow-up time of 16 months, no recurrence of symptoms associated with lead perforation or CIED-related infection were reported. CONCLUSION: In most patients with lead perforation, TLE can be a safe and effective management approach.
Zhou et al. (Mon,) conducted a observational in Cardiac perforation caused by a transvenous lead (n=53). Transvenous lead extraction (TLE) was evaluated on Complete removal of culprit leads without major complications. Transvenous lead extraction safely removed perforated leads in 100% of patients (53/53) without major complications or new pericardial effusion over a median 16-month follow-up.
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