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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Extraction of pacemaker and implantable cardioverter defibrillator leads: patient and lead characteristics in relation to the requirement of extraction tools.
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Extraction of pacemaker and implantable cardioverter defibrillator leads: patient and lead characteristics in relation to the requirement of extraction tools.

机译：起搏器和植入式心脏复律除颤器导线的拔出：与拔出工具的要求有关的患者和导线特性。

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Effective tools for extraction of pacemaker and ICD leads have been developed in the past decennium. This study investigated the necessity of using these tools in addition to direct traction in relation to patient and lead characteristics. The study encompasses first attempts at extraction of consecutive pacemaker and ICD leads from the subpectoral area. A stepwise extraction protocol was used with traction first (directly or with a locking stylet) followed by laser sheath extraction if not successful. The indication, patient age, time from implant, fixation mechanism, location, and insertion site of the leads were studied in relation to the outcome of traction. A total of 145 leads in 83 patients were extracted. Leads were implanted for 71 +/- 61 months. Indication for extraction was infection in 96 leads and malfunction in 49 leads. There were 90 ventricular leads including 16 ICD leads. Forty-nine (34%) leads were extracted with traction; in 96 (66%) leads a laser sheath was necessary. All leads implanted for < 6 months could be removed with traction alone. In a multivariate logistic regression model, time from implant was the main factor determining success of traction (P < 0.001), but in case of infection the success rate increased (P = 0.004). In conclusion, time from implant is the decisive factor to judge the potential efficacy of lead extraction with direct traction. If leads are implanted for 6 months, the availability of additional extraction tools is necessary when lead extraction is considered. In addition to time from implant, infected leads have a better chance to be removed with traction although it is a much weaker predictor.
机译：在过去的十年中，开发了有效的工具来提取起搏器和ICD导线。这项研究调查了除了直接牵拉患者和导线特性外，还使用这些工具的必要性。该研究包括从胸膜下区域提取连续起搏器和ICD导线的首次尝试。如果不成功，则先进行牵引（直接或使用锁定管心针）进行逐步提取，然后再进行激光鞘层提取。研究了牵引力的指征，患者年龄，植入时间，固定机制，导线的位置和插入部位。提取了83例患者中的145条线索。导线植入了71 +/- 61个月。提取的指征是96根导线感染，49根导线故障。有90条心室导线，包括16条ICD导线。通过牵引提取了四十九（34％）个导线;在96（66％）根导线中，需要使用激光护套。植入时间少于6个月的所有引线都可以单独通过牵引去除。在多因素logistic回归模型中，植入时间是决定牵引成功与否的主要因素（P <0.001），但在感染的情况下成功率增加（P = 0.004）。总之，植入时间是决定直接牵引引出铅的潜在疗效的决定性因素。如果将铅植入了6个月，则在考虑铅提取时，有必要使用其他提取工具。除了植入时间外，受感染的导线更容易被牵引移除，尽管它的预测力要弱得多。

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