Hands on: How to approach patients undergoing lead extraction.

Journal Article (Journal Article;Review)

Due to the growing number of patients treated with cardiac implantable electronic devices (CIEDs) there is an increased need for lead management, evaluation, and extraction. While CIED lead extraction has many indications, a consistent approach to preprocedural planning should be applied in all cases, including a thorough consultation with careful review of the patient's medical and device history, as well as a discussion of informed consent and shared decision-making with the patient and their loved ones. The use of chest X-ray, echocardiography, and computed tomography (CT) scan can further help with risk stratification and procedural planning. Intraprocedural echocardiography (transesophageal or intracardiac) is recommended and allows early recognition of cardiothoracic injury. Establishing an extraction team with cardiology/electrophysiology, anesthesiology, and CT surgery is is crucial to a successful and safe CIED extraction practice, including immediately available surgical backup. This hands-on review will address how to approach patients who are undergoing lead extraction, as well as several innovations in preprocedure and intraprocedural risk assessment.

Full Text

Duke Authors

Cited Authors

  • Lewis, RK; Pokorney, SD; Hegland, DD; Piccini, JP

Published Date

  • July 2020

Published In

Volume / Issue

  • 31 / 7

Start / End Page

  • 1801 - 1808

PubMed ID

  • 31626390

Pubmed Central ID

  • 31626390

Electronic International Standard Serial Number (EISSN)

  • 1540-8167

Digital Object Identifier (DOI)

  • 10.1111/jce.14244

Language

  • eng

Conference Location

  • United States