Source:http://linkedlifedata.com/resource/pubmed/id/10527016
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
9
|
| pubmed:dateCreated |
1999-11-15
|
| pubmed:abstractText |
Of the 400,000-500,000 permanent pacemaker leads implanted worldwide each year, around 10% may eventually fail or become infected, becoming potential candidates for removal. Intravascular techniques for removing problematic or infected leads evolved over a 5-year period (1989-1993). This article analyzes results from January 1994 through April 1996, a period during which techniques were fairly stable. Extraction of 3,540 leads from 2,338 patients was attempted at 226 centers. Indications were: infection (27%), nonfunctional or incompatible leads (25%), Accufix or Encore leads (46%), or other causes (2%). Patients were 64+/-17 years of age (range 5-96); 59% were men, 41% women. Leads were implanted 47+/-41 months (maximum 26 years), in the atrium (53%), ventricle (46%), or SVC (1%). Extraction was attempted via the implant vein using locking stylets and dilator sheaths, and/or transfemorally using snares, retrieval baskets, and sheaths. Complete removal was achieved for 93% of leads, partial for 5%, and 2% were not removed. Risk of incomplete or failed extraction increased with implant duration (P<0.0001), less experienced physicians (P<0.0001), ventricular leads (P<0.005), noninfected patients (P<0.0005), and younger patients (P<0.0001). Major complications were reported for 1.4% of patients (<1% at centers with >300 cases), minor for 1.7%. Risk of complications increased with number of leads removed (P<0.005) and with less experienced physicians (P<0.005); risk of major complications was higher for women (P<0.01). Given physician experience, appropriate precautions, and appropriate patient selection, contemporary lead removal techniques allow success with low complication rates.
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| pubmed:commentsCorrections | |
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Sep
|
| pubmed:issn |
0147-8389
|
| pubmed:author |
pubmed-author:ByrdC LCL,
pubmed-author:CreveyBB,
pubmed-author:FearnotN ENE,
pubmed-author:FreedmanRR,
pubmed-author:FriedmanRR,
pubmed-author:GoldFF,
pubmed-author:KutalekS PSP,
pubmed-author:LouwC WCW,
pubmed-author:OrenJJ,
pubmed-author:ReevesRR,
pubmed-author:SchutzmanJJ,
pubmed-author:SellersT DTD,
pubmed-author:TranthamJJ,
pubmed-author:TurkK TKT,
pubmed-author:Van ZandtH JHJ,
pubmed-author:WattsMM,
pubmed-author:WilkoffB LBL,
pubmed-author:WilsonJJ,
pubmed-author:YoungRR
|
| pubmed:issnType |
Print
|
| pubmed:volume |
22
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
1348-57
|
| pubmed:dateRevised |
2006-11-15
|
| pubmed:meshHeading |
pubmed-meshheading:10527016-Adolescent,
pubmed-meshheading:10527016-Adult,
pubmed-meshheading:10527016-Aged,
pubmed-meshheading:10527016-Aged, 80 and over,
pubmed-meshheading:10527016-Child,
pubmed-meshheading:10527016-Child, Preschool,
pubmed-meshheading:10527016-Device Removal,
pubmed-meshheading:10527016-Equipment Failure,
pubmed-meshheading:10527016-Female,
pubmed-meshheading:10527016-Humans,
pubmed-meshheading:10527016-Infection,
pubmed-meshheading:10527016-Logistic Models,
pubmed-meshheading:10527016-Male,
pubmed-meshheading:10527016-Middle Aged,
pubmed-meshheading:10527016-Odds Ratio,
pubmed-meshheading:10527016-Pacemaker, Artificial,
pubmed-meshheading:10527016-Risk Factors
|
| pubmed:year |
1999
|
| pubmed:articleTitle |
Intravascular extraction of problematic or infected permanent pacemaker leads: 1994-1996. U.S. Extraction Database, MED Institute.
|
| pubmed:affiliation |
University of Miami School of Medicine, Florida, USA.
|
| pubmed:publicationType |
Journal Article,
Research Support, Non-U.S. Gov't
|