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Because of the increasing use of cardiac implantable electronic devices (CIEDs) with one or more intracardiac electrodes, the rate of lead failure is increasing. Moreover, upgrade of the CIED frequently is indicated for cardiac resynchronization therapy or other reasons. Both these situations require a new intervention, preferably using ipsilateral venous access. However, venous obstruction after CIED insertion occurs in 10%-20% of patients and poses a major obstacle for implantation of additional leads. Possible solutions include lead extraction, contralateral lead insertion, and venoplasty. Preprocedural venoplasty is associated with the lowest short- and long-term risks. Here we describe a step-by-step approach to this technique, which can be introduced and safely performed in most interventional catheterization laboratories.
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Erik Lipšic
Fenna Daniëls
Hessel F. Groenveld
Heart Rhythm
University of Groningen
University Medical Center Groningen
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Lipšic et al. (Mon,) studied this question.
www.synapsesocial.com/papers/68e6d064b6db64358764e73c — DOI: https://doi.org/10.1016/j.hrthm.2024.04.088