Working on the dirty side-the ipsilateral subclavian access for temporary pacing after lead extraction.
Transvenous lead extraction
cardiovascular implantable electrical device
pocket infection
subclavian access
Journal
Journal of arrhythmia
ISSN: 1880-4276
Titre abrégé: J Arrhythm
Pays: Japan
ID NLM: 101263026
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
04
08
2021
revised:
23
12
2021
accepted:
09
01
2022
entrez:
7
4
2022
pubmed:
8
4
2022
medline:
8
4
2022
Statut:
epublish
Résumé
Temporary pacing is necessary in pacemaker-dependent patients after transvenous lead extraction (TLE) for cardiac implantable electronic device infection. In case of unavailability of other accesses, we propose to use the ipsilateral subclavian access (ISA) combined with a standard permanent active fixation lead for the temporary pacemaker and present preliminary data. We consecutively enrolled patients undergoing TLE who received a temporary pacemaker using the ISA between August 2016 and April 2020 at our centre. During the observation period, 36 patients undergoing TLE for pocket infection (72.2%), endocarditis (25.0%) or other causes received a temporary pacemaker over the ISA. Their mean age was 77.0 ± 10.7 years, and 13.9% were female. Complete TLE was achieved in 94.4%. There were no major periprocedural complications. Intra-hospital mortality was 11.1%. Pocket revision was performed in 19.4%. During long-term follow-up (23 ± 13 months), 8.3% had a relapse of local pocket infection and 2.8% needed rehospitalization for reintervention. Temporary pacing using a standard permanent active fixation lead using the ISA is a convenient alternative to conventional venous accesses. However, risks of implanting a lead into a previously infected area have to be taken into account.
Sections du résumé
Background
UNASSIGNED
Temporary pacing is necessary in pacemaker-dependent patients after transvenous lead extraction (TLE) for cardiac implantable electronic device infection. In case of unavailability of other accesses, we propose to use the ipsilateral subclavian access (ISA) combined with a standard permanent active fixation lead for the temporary pacemaker and present preliminary data.
Methods
UNASSIGNED
We consecutively enrolled patients undergoing TLE who received a temporary pacemaker using the ISA between August 2016 and April 2020 at our centre.
Results
UNASSIGNED
During the observation period, 36 patients undergoing TLE for pocket infection (72.2%), endocarditis (25.0%) or other causes received a temporary pacemaker over the ISA. Their mean age was 77.0 ± 10.7 years, and 13.9% were female. Complete TLE was achieved in 94.4%. There were no major periprocedural complications. Intra-hospital mortality was 11.1%. Pocket revision was performed in 19.4%. During long-term follow-up (23 ± 13 months), 8.3% had a relapse of local pocket infection and 2.8% needed rehospitalization for reintervention.
Conclusions
UNASSIGNED
Temporary pacing using a standard permanent active fixation lead using the ISA is a convenient alternative to conventional venous accesses. However, risks of implanting a lead into a previously infected area have to be taken into account.
Identifiants
pubmed: 35387138
doi: 10.1002/joa3.12677
pii: JOA312677
pmc: PMC8977584
doi:
Types de publication
Journal Article
Langues
eng
Pagination
192-198Informations de copyright
© 2022 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society.
Déclaration de conflit d'intérêts
David Zweiker received speaker honoraria and travel grants from Daiichi Sankyo and research grants from Boston Scientific. Patrizio Mazzone is a proctor for Cook Medical. All other authors report no conflict of interest whatsoever.
Références
Europace. 2014 Feb;16(2):252-7
pubmed: 23902652
Heart Rhythm. 2017 Dec;14(12):e503-e551
pubmed: 28919379
Heart Rhythm. 2009 Jul;6(7):1085-104
pubmed: 19560098
Europace. 2012 Jul;14(7):981-5
pubmed: 22213794
J Innov Card Rhythm Manag. 2019 May 15;10(5):3652-3661
pubmed: 32477730
Europace. 2020 Apr 1;22(4):613-621
pubmed: 32087025
J Am Coll Cardiol. 2010 Feb 9;55(6):579-86
pubmed: 20152562
J Clin Nurs. 2017 Dec;26(23-24):3962-3973
pubmed: 28334482
Circ Arrhythm Electrophysiol. 2017 Mar;10(3):
pubmed: 28292753
JACC Clin Electrophysiol. 2020 Jan;6(1):94-106
pubmed: 31709982
Eur Heart J. 2017 Oct 21;38(40):2995-3005
pubmed: 28369414
J Cardiovasc Electrophysiol. 2019 Apr;30(4):569-574
pubmed: 30661279
J Thorac Cardiovasc Surg. 2013 Aug;146(2):302-5
pubmed: 22964353
Eur Heart J. 2015 Nov 21;36(44):3075-3128
pubmed: 26320109
J Am Coll Cardiol. 2011 Aug 30;58(10):1001-6
pubmed: 21867833
Pacing Clin Electrophysiol. 2019 Jul;42(7):989-997
pubmed: 30997679
J Cardiovasc Electrophysiol. 2021 Nov;32(11):3051-3056
pubmed: 34487387
J Innov Card Rhythm Manag. 2019 Dec 15;10(12):3930-3936
pubmed: 32477715
JACC Clin Electrophysiol. 2020 Mar;6(3):304-310
pubmed: 32192681
Europace. 2018 Apr 1;20(4):e42-e50
pubmed: 28582500
J Arrhythm. 2020 Feb 14;36(2):343-350
pubmed: 32256885
Nurs Res Pract. 2015;2015:796762
pubmed: 26075093