In the last years, indications for defibrillators and cardiac resynchronization therapy have expanded enormously; for this reason, and also due to the extension of human life lengthm the number of patients with implanted cardiac devices have steadily increased. The leads implanted for the functioning of these devices, however, have a limited duration in time and more and more their extraction will be a frequent issue in clinical practice, in order to treat short- and long-term complications, such as infections and failures.
Aim of this book is to provide readers with a state-of-the-art on lead extraction techniques. The chapters deal with leads characteristics, indications to lead removal, patient preparation, tools and techniques for extraction, and prevention and management of complications. In addition, a series of tips and tricks on how to treat some particular conditions (tight cost-clavicular space, fractured leads, ICD leads, dangered leads…etc.), are given. A new extracting technique, according to which the extraction is performed through the internal jugular vein is described; several examples are included and many figures provide a thorough depiction of this innovative procedure.
The volume will be an excellent resource for all those involved in the management of cardiac patients: cardiologists, arrhythmologists, cardiac surgeons, GPs, pediatricians, and post-graduate students in these disciplines.
Written for: Cardiologists, arrhythmologists, cardiac surgeons
Part 1: Importance to know the lead: Pacing Leads. ICD Leads. LV Leads.- Part 2: Indications to Lead Removal: Infective. Not infective.- Part 3: Planning of the Procedures: Pre-interventional Patient Evaluation. Informed Consent. Patient Preparation. Anaesthesia.- Part 4: Tools for Extraction: Single Traction. Locking Stylets. Mechanical Dilators. Powered Sheaths. Transfemoral Tools. Others.- Part 5: Techniques: Venous Entry Approach. Transfemoral Approach. Internal Transjugular Approach.- Part 6: The utility of Intracardiac and Intravascular Echography: Before the procedure. During the procedure. After the procedure.- Part 7: Prevention and Treatment of Complications. Major Complications. Minor Complications.- Part 8: Implantation of a New Lead: In Presence of Infections. In Absence of Infections.- Part 9: Problem solving: Description of 10 complex situations