Implantable Cardioverter-Defibrillator Lead Extraction by Conventional Traction and Counter-Traction Technique

A 65-year-old man was evaluated for chronic chest pain that had been present for 8 years after placement of a dual-chamber implantable cardioverter-defibrillator to treat inducible ventricular tachycardia. Previous coronary angiography had revealed nonobstructive coronary artery disease and a left ventricular ejection fraction of 0.45 to 0.50, consistent with mild idiopathic nonischemic cardiomyopathy. Evaluation with chest radiography and transthoracic echocardiography showed the implantable cardioverter-defibrillator lead to be embedded within the right ventricle at the moderator band, which had mild calcification. Treatment included extraction of the dual-coil lead and placement of a new single-coil right ventricular lead at the mid septum. The patient had complete relief of symptoms after the procedure. This case shows that chest pain can be associated with the placement of a right ventricular implantable cardioverter-defibrillator lead in the moderator band and that symptomatic relief can occur after percutaneous lead extraction and the implantation of a new right ventricular lead to the mid septal region.

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Fighting fungus with a laser and a hose: Management of a giant Candida albicans implantable cardioverter-defibrillator lead vegetation with simultaneous AngioVac aspiration and laser sheath lead extraction

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.27153 ◽

2017 ◽

Vol 91 (2) ◽

pp. 318-321 ◽

Cited By ~ 9

Author(s):

Brandon M. Jones ◽

Oussama Wazni ◽

Susan J. Rehm ◽

Mehdi H. Shishehbor

Keyword(s):

Candida Albicans ◽

Implantable Cardioverter Defibrillator ◽

Lead Extraction ◽

Cardioverter Defibrillator ◽

Defibrillator Lead

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Pacemaker and Implantable Cardioverter Defibrillator Lead Extraction

An Atlas of Radioscopic Catheter Placement for the Electrophysiologist ◽

10.1007/978-1-84800-227-2_11 ◽

2008 ◽

pp. 265-286

Author(s):

Michela Casella ◽

Antonio Dello Russo

Keyword(s):

Implantable Cardioverter Defibrillator ◽

Lead Extraction ◽

Cardioverter Defibrillator ◽

Defibrillator Lead

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Transesophageal Echocardiographic Diagnosis of Severe Functional Tricuspid Stenosis During Infected Implantable Cardioverter-Defibrillator Lead Extraction

Journal of Cardiothoracic and Vascular Anesthesia ◽

10.1053/j.jvca.2014.07.013 ◽

2015 ◽

Vol 29 (2) ◽

pp. 412-416 ◽

Cited By ~ 1

Author(s):

Michael Essandoh ◽

Alix Zuleta-Alarcon ◽

Raul Weiss ◽

John Sirak ◽

Galina Dimitrova ◽

...

Keyword(s):

Implantable Cardioverter Defibrillator ◽

Lead Extraction ◽

Cardioverter Defibrillator ◽

Defibrillator Lead

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Forces Applied during Transvenous Implantable Cardioverter Defibrillator Lead Removal

BioMed Research International ◽

10.1155/2014/183483 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Carsten Lennerz ◽

Herribert Pavaci ◽

Christian Grebmer ◽

Gesa von Olshausen ◽

Verena Semmler ◽

...

Keyword(s):

Implantable Cardioverter Defibrillator ◽

Traction Force ◽

Friction Loss ◽

Lead Extraction ◽

Lead Removal ◽

Safe Procedure ◽

Traction Forces ◽

Cardioverter Defibrillator ◽

Icd Leads ◽

Defibrillator Lead

Methods. 17 physicians, experienced in transvenous lead removal, performed a lead extraction manoeuvre of an ICD lead on a torso phantom. They were advised to stop traction only when further traction would be considered as harmful to the patient or when—based on their experience—a change in the extraction strategy was indicated. Traction forces were recorded with a digital precision gauge.Results. Median traction forces on the endocardium were 10.9 N (range from 3.0 N to 24.7 N and interquartile range from 7.9 to 15.3). Forces applied to the proximal end were estimated to be 10% higher than those measured at the tip of the lead due to a friction loss.Conclusion. A traction force of around 11 N is typically exerted during standard transvenous extraction of ICD leads. A traction threshold for a safe procedure derived from a pool of experienced extractionists may be helpful for the development of required adequate simulator trainings.

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