Retrospective Clinical Analysis on Lead Extraction and Reimplantation Strategies,Success and Complication Rates During Upgrade of Cardiovascular Implantable Electronic Devices in Non-infected Patients
10.3969/j.issn.1000-3614.2025.02.009
- VernacularTitle:非感染患者心血管植入型电子器械升级时导线拔除及再植入的回顾性临床分析
- Author:
Cuizhen YUAN
1
;
Feng ZE
1
;
Ding LI
1
;
Jiangbo DUAN
1
;
Xu ZHOU
1
;
Cuncao WU
1
;
Jinshan HE
1
;
Long WANG
1
;
Xuebin LI
1
Author Information
1. 北京大学人民医院 心内科,北京 100044
- Publication Type:Journal Article
- Keywords:
cardiovascular implantable electronic devices;
upgrade;
lead extraction;
lead abandonment;
reimplantation
- From:
Chinese Circulation Journal
2025;40(2):170-174
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To analyze the clinical characteristics,strategies,success and complication rates of lead extraction and re-implantation during the upgrade of cardiovascular implantable electronic devices(CIED)in non-infectious patients.Methods:This retrospective study collected and analyzed the baseline clinical data and surgical data of 66 non-infected patients who had their existing CIEDs(including cardiac pacemaker,implantable cardioverter defibrillator[ICD],cardiac resynchronization therapy pacemaker[CRT-P])upgraded to ICD or CRT-P or cardiac resynchronization therapy defibrillator(CRT-D)or subcutaneous implantable cardioverter defibrillator(S-ICD)in Peking University People's Hospital from March 2018 to March 2024.We analyzed the strategies of lead extraction and reimplantation as well as the operation success rate and complication rate.Results:Among the 66 patients,preoperative imaging revealed that 12 patients(18.2%)had severe stenosis/occlusion of the venous access route,with lead wear/perforation in 26 patients(39.4%).32 patients(48.5%)underwent transvenous lead extraction(TLE),of which all leads were removed in 27 patients(84.4%),and only non-functional leads were removed in 5 patients(15.6%).The success rate of the TLE procedure was 100%and no complication occurred.Among the 66 patients,functional leads retained and new leads were implanted on the same side in 28 patients(42.4%),all leads were removed and new leads were reimplanted on the opposite side in 22 patients(33.3%),only non-functional leads were removed and new leads were reimplanted on the same side in 5 patients(7.6%),all leads were removed and new leads were reimplanted on the same side in 5 patients(7.6%),and 6 patients(9.1%)had the leads abandoned and then were re-implanled.The success rate of the upgrade surgery was 100%,no complications were reported.Conclusions:When the existing CIEDs(including cardiac pacemaker,ICD,CRT-P)of non-infected patients are upgraded to ICD,CRT-P,CRT-D or S-ICD,lead extraction and reimplantation are safe and feasible,and reimplantation can be performed on the ipsilateral or contralateral side.
