Cardiac and Vascular Injuries Sustained During Transvenous Lead Extraction

摘要

The rapid rise in indications for cardiac implant-able electronic devices has necessitated the development of tools for removal of the electrodes that connect the heart to these externally located pacemakers and defibrillators. Almost immediately after the implant of a cardiac electrode, there is clear evidence of the development of fibrous attachments to the heart and vascular structures that they traverse.1 The natural history of this fibrosis is one of variable but progressive fibrous adhesion. Eventually, most electrodes develop strong fibrous attachments at the point of entry to the vein, areas of contact within veins they traverse, the tricuspid valve, and finally in the area of contact within cardiac chambers that are sensed and paced.