Experience of Cardiovascular Implantable Electronic Device Extraction

概要

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As the number of cardiovascular implantable electronic device (CIED) implantation is increasing, the number of complication is also increasing such as infection, lead fracture or lead perforation. In Japan, we have been able to use Excimer laser since July 2010, we could extract CIED with minimum injury. In our hospital, we have had 15 patients who needed of CIED extraction, including those referred to our hospital. The main reason of CIED extraction was CIED infection in 13 of 15 patients. CIED in 8 patients were extracted by Excimer laser. CIED in 5 of 8 patients were extracted in our hospital. Ten leads in 5 patients could be extracted percutaneously. However, one patient was necessary of sternotomy because we could not catch the lead percutaneously from left subclavian approach and could not extract from femoral approach. After sternotomy, we could catch the lead from innominate vein, and we could extract it by Excimer laser. Seven of 10 leads, one was ICD lead and 6 were pacemaker leads, were extracted by Excimer laser. The mean period from implantation to extraction was 7.6 years and the mean extraction time was 47 minutes. All 7 leads in 5 patients were successfully explanted with no complication.
日本不整脈学会の論文