© 2003 by European Society of Cardiology
Unusual extraction of an active fixation ventricular pacing lead with outer coil fracture in a child
Paediatric Cardiology Unit, Hacettepe University Faculty of Medicine Sihhiye, Ankara, 06100, Turkey
AIM: In this report we describe an asymptomatic paced child with outer coil fracture of the bipolar screw-in steroid eluting ventricular lead without insulation defect, loss of ventricular capture and unexpected increase in lead impedance in the bipolar VVIR pace configuration.
METHOD AND RESULT: A previously unpublished method was performed to retract the helix and the lead. As a result, the fractured lead was successfully retrieved.
CONCLUSION: We suggest that, this unusual extraction method can be tried as an alternative approach in the removal of an active fixation ventricular pacing lead with impaired mechanical function possibly due to fracture.
Key Words: Pacing in children, screw-in electrode, pacing lead extraction, subclavian view approach for transvenous pacing
Correspondence: Prof. Dr Alpay Celiker, M.D., Paediatric Cardiology Unit, Ihsan Dogramaci Children's Hospital, Hacettepe University, Sihhiye, Ankara 06100, Turkey. Tel.: +90 (312) 305 11 57; Fax: +90 (312) 309 02 20; E-mail: alpayceliker{at}hotmail.com
[1] Byrd CL, Schwartz SC, Hedin N. Lead extraction: indications and techniques. Cardiol Clin 1992; 10: 735748.[Medline]
[2] Smith HJ, Fearnot NE, Byrd CL, et al. Five-years experience with intravascular lead extraction. U.S. Lead Extraction Database. Pacing Clin Electrophysiol 1994; 17: 20162020.[CrossRef][Medline]
[3] Bracke FA, Meijer A, Gelder BV. Learning curve characteristics of pacing lead extraction with a laser sheath. Pacing Clin Electrophysiol 1998; 21: 23092313.[CrossRef][Medline]
[4] Celiker A, Kafali G, Ozer S, Ozme S. Outcome of pediatric patients with transvenous pacemaker or lead revision. Cardiol Young 2001; 11:Supp. 1, P1184.
[5] Friedman RA, Van Zandt H, Collins E, LeGras M, Perry J. Lead extraction in young patients with and without congenital heart disease using the subclavian approach. Pacing Clin Electrophysiol 1996; 19: 778783.[Medline]
[6] Magney JE, Staplin DH, Flynn DM, Hunter DW. A new approach to percutaneous subclavian venipuncture to avoid lead fracture or central venous catheter occlusion. Pacing Clin Electrophysiol 1993; 16: 21332142.[Medline]
[7] Brodell GK, Castle LW, Maloney JD, Wilkoff BL. Chronic transvenous pacemaker lead removal using a unique, sequential transvenous system. Am J Cardiol 1990; 66: 964966.[Medline]
[8] Fearnot NE, Smith HJ, Goode LB, Byrd CL, Willkoff BL, Sellers TD. Intravascular lead extraction using locking stylets, sheaths, and other techniques. Pacing Clin Electrophysiol 1990; 13: 18641870.[Medline]
[9] Espinosa RE, Hayes DL, Vlietstra RE, Osborn MJ, McGoon MD. The Dotter retriever and pigtail catheter: efficacy in extraction of chronic transvenous pacemaker leads. Pacing Clin Electrophysiol 1993; 16: 23372342.[CrossRef][Medline]
[10] Kennergren C. Excimer laser assisted extraction of permanent pacemaker and ICD leads: present experiences of a European multi-centre study. Eur J Cardiothorac Surg 1999; 15: 856860.
[11] Byrd CL, Wilkoff BL, Love CJ, et al. Intravascular extraction of problematic or infected permanent pacemaker leads: 19941996. U.S. Extraction Database, MED Institute. Pacing Clin Electrophysiol 1999; 22: 13481357.[CrossRef][Medline]
[12] Suzuki Y, Fujimori S, Sakai M, et al. A case of pacemaker lead fracture associated with thoracic outlet syndrome. Pacing Clin Electrophysiol 1988; 11: 326330.[Medline]
[13] Schuger C, Mittleman R, Habbal B, et al. Ventricular lead transection and atrial lead damage in a young softball player shortly after the insertion of a permanent pacemaker. Pacing Clin Electrophysiol 1992; 15: 12361239.[Medline]
[14] Magney JE, Flynn DM, Parsons JA, et al. Anatomical mechanisms explaining damage to pacemaker leads, defibrillator leads, failure of central venous catheters adjacent to the sternoclavicular joint. Pacing Clin Electrophysiol 1993; 16: 445457.[CrossRef][Medline]
[15] Jacobs DM, Fink AS, Miller RP, et al. Anatomical and morphological evaluation of pacemaker lead compression. Pacing Clin Electrophysiol 1993; 16: 434444.[Medline]
![]()
CiteULike
Connotea
Del.icio.us What's this?
This article has been cited by other articles:
![]() |
H. Olgun, T. Karagoz, A. Celiker, and N. Ceviz Patient- and lead-related factors affecting lead fracture in children with transvenous permanent pacemaker Europace, July 1, 2008; 10(7): 844 - 847. [Abstract] [Full Text] [PDF] |
||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
