The morphological conditions of the permanent pacemaker lead extraction

• Autorzy: Kozlowski D , Dubaniewicz A. , Kozluk E. , Grzybiak M. , Krupa W. , Kolodziej P. , Pazdyga A. , Adamowicz-Kornacka M. , Walczak E. , Walczak F.
• Języki publikacji: EN

Abstrakty

EN

Pacemaker lead extraction is the treatment of choice in infectious complications regarding implantation procedure. The purpose of this study was to estimate the safety of the extraction in relation to the morphological changes of the pacing electrode. Research was carried out on materials consisting of 60 human hearts from 45 to 95 years of age (average 63 ± 15 yrs), with VVI or DDD pacing (pacing duration 84 ± 26 months) fixed in a formalin solution. Classical macroscopic anatomical methods were applied. In 44 hearts (73.3%) from the investigated group the posterior tricuspid leaflet was thickened only, and in 24 of these hearts the process regarded not only posterior leaflet but also the septal one and especially commissure between them. In 52 hearts (86.6%) inflammatory reaction spread also to the neighbouring part of the electrode. The length of the neointima-inflammatory tissue ranged from 4 to 8 mm (average 5 ± 2 mm). On the tip of the electrode in the right ventricle cavity in 56 hearts (93.3%) we observed that endocardial leads were surrounded by fibrous thickening , and partially covered by endocardial tissue. We concluded that from the anatomical point of view the extraction of the pacing electrode seems to be questionable, especially in long-term permanent pacing. The experimental traction shows that only recently implanted electrodes were removed without any complications and in others with fraction of the tip, myocardial tissue avulsion or such removal was not successful at all.

Słowa kluczowe

EN

anatomical condition; cardiac disease; morphology; permanent pacemaker lead

• Wydawca: -
• Czasopismo: Folia Morphologica
• Rocznik: 2000
• Tom: 59
• Numer: 1
• Opis fizyczny: p.25-29,fig.

Twórcy

autor

Kozlowski D

• Medical University of Gdansk, 1 Kieturakisa St., 80-742 Gdansk, Poland

autor

Dubaniewicz A.

autor

Kozluk E.

autor

Grzybiak M.

autor

Krupa W.

autor

Kolodziej P.

autor

Pazdyga A.

autor

Adamowicz-Kornacka M.

autor

Walczak E.

autor

Walczak F.

Bibliografia

• 1. Barbetseas J, Lalos S, Kyriakidis M, Aggeli C, Toutouzas P (1998) Role of transesophageal echocardiography in the diagnosis of infected retained pacing lead. Pacing Clin Electrophysiol, 21: 1159–1161.
• 2. Byrd CL, Schwartz SJ, Hedin NB, Goode LB, Fearnot NE, Smith HJ (1990) Intravascular lead extraction using locking stylets and sheats. Pacing Clin Electrophysiol, 13: 1871–1875.
• 3. Byrd CL, Schwartz SJ, Hedin N (1991) Intravascular techniques for extraction of permanent pacemaker leads. J Thorac Cardiovasc Surg, 101: 989–997.
• 4. Colavita PG, Zimmern SH, Gallagher JJ, Fedor JM, Austin WK, Smith HJ (1993) Intravascular extraction of chronic pacemaker leads: efficacy and follow-up. Pacing Clin Electrophysiol, 16: 2333–2336.
• 5. Ebe K, Funazaki T, Aizawa Y, Shibata A, Fukuda T (1991) Experimental study about removal of the implanted tined polyurethane ventricular lead by radiofrequency waves through the lead. Pacing Clin Electrophysiol, 14: 1222–1227.
• 6. Espinosa ER, Hayes DL, Vlietstra RE, Osborn MJ, McGoon MD (1993) The dotter retriever and pigtail catheter: efficacy in extraction of chronic transvenous pacemaker leads. Pacing Clin Electrophysiol, 16: 2337–2342.
• 7. Fearnot NE, Smith HJ, Goode LB, Byrd CL, Wilkoff BL, Sellers TD (1990) Intravascular lead extraction using locking stylets, sheats, and other techniques. Pacing Clin Electrophysiol, 13: 1864–1870.
• 8. Kozlowski D, Dubaniewicz A, Kozluk E, Adamowicz M, Grzybiak M, Walczak E (1997) Possible mechanism of the tricuspid valve insufficiency in the permanent right ventricular pacing. A morphological study. Cardiac Pacing, Monduzzi Editore, Bologna, 31–35.
• 9. Legergren H, Dahlgren S, Nordenstam H (1966) Cardiovascular tissue response to intracardiac pacemaking. Acta Chir Scand, 132: 696–673.
• 10. Madigan NP, Curtis JJ, Sanfelippo JF, Murphy TJ (1984) Difficulty of extraction of chronically implanted ventricular endocardial leads. J Am Coll Cardiol, 3: 724–731.
• 11. Myers MR, Parsonnet V, Bernstein AD (1991) Extraction of implanted transvenous pacing leads: a review of persistent clinical problem. Am Heart J, 121: 881–888.
• 12. Robboy SJ, Harthorne JW, Leinbach RC, Sanders CA, Austen WG (1969) Autopsy findings with permanent pervenous pacemakers. Circulation, 39: 495–501.
• 13. Sloman G, Strathmore N (1993) Permanent pacemaker lead extraction. Pacing Clin Electrophysiol, 16: 2331–2332.