Uniportal Video-Assisted Thoracotomy during Excimer Laser-Guided Cardiac Implantable Electronic Devices Lead Extraction: A 5-Year Single-Centre Experience

Abstract Aims Mood disorders are common in patients with cardiac implantable electronic devices (CIEDs). The COVID-19 pandemic may have further undermined their emotional well being exacerbating physical symptoms such as palpitations. We investigated the occurrence of anxiety and palpitations in CIEDs patients during the pandemic. In those with remote monitoring (RM) available, we evaluated whether these symptoms were associated with arrhythmic events. Methods and results The generalized anxiety disorder (GAD) 7-items questionnaire and the frequency of palpitations were assessed by telephonic interview. Overall 152 CIEDs patients agreed to be interviewed (119 males, age 69 ± 14 years). The RM was available in 54/152 (36%). Thirty-seven (24%) and 43 (28%) patients had anxiety and palpitations, respectively, and 23 (15%) patients had both. Women were more likely to have symptoms than men (50% vs. 20%; P < 0.01 for anxiety and 53% vs. 24%; P < 0.01 for palpitations). Among patients with palpitations the RM was available in 17/43 (40%) and revealed true arrhythmic events in 7/17 (41%) patients: eight non-sustained ventricular tachycardias (NSVT), two supra-ventricular tachycardias (SVT), four sustained ventricular tachycardias (VT). The RM enabled to detect in six patients a device malfunctioning: in two increased impedance in the shock lead, in three increased capture threshold for the LV lead and in one the battery reached the end of life. Conclusions Patients with CIEDs were likely to experience anxiety and palpitations during the COVID-19 outbreak and the RM has been pivotal to ascertain the occurrence of arrhythmic events and device malfunctioning in symptomatic and asymptomatic patients as well.

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12 Cardiac implantable electronic devices complications – a single centre experience

Heart ◽

10.1136/heartjnl-2015-308621.12 ◽

2015 ◽

Vol 101 (Suppl 5) ◽

pp. A6-A7

Author(s):

N Ryan ◽

N Mahon ◽

K Walsh ◽

J O’Neill ◽

E Keelan ◽

...

Keyword(s):

Electronic Devices ◽

Single Centre ◽

Cardiac Implantable Electronic Devices ◽

Single Centre Experience

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A Novel Video-Assisted Approach to Excimer Laser-Guided Cardiac Implantable Electronic Devices Lead Extraction

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0000000000000277 ◽

2016 ◽

Vol 11 (3) ◽

pp. 210-213

Author(s):

Patrick Zardo ◽

Henning Busk ◽

Johannes Hadem ◽

Hassina Baraki ◽

George Kensah ◽

...

Keyword(s):

High Risk ◽

Real Time ◽

Laser Sheet ◽

Electronic Devices ◽

Lead Extraction ◽

Clinical Value ◽

High Risk Patients ◽

Video Assisted ◽

Cardiac Implantable Electronic Devices ◽

Risk Patients

Objective Even though roughly 90% of all implanted cardiac implantable electronic devices leads can be removed through conventional techniques, presence of large vegetations or thrombi, fractured leads, previous failed extraction, or long duration from implantation often impede classical transvenous extraction. In these cases, laser-assisted procedures represent a highly successful alternative and have a low procedural complication rate with major adverse events in less than 2% of cases. Unfortunately, most encountered complications are potentially fatal, which prompted us to develop a novel approach that adds additional safety measures by allowing for real-time intrathoracic visualization and intervention. Methods Five consecutive patients classified as high-risk patients received concomitant laser sheet extraction and right-sided uniportal video-assisted thoracic surgery for real-time intrathoracic visualization. Results Complete extraction was achieved in all cases without observing major intraoperative events, and on-table extubation was feasible in all cases. No chest tube-associated or incision-related complications were encountered. Conclusions Concomitant laser sheet extraction and video-assisted thoracoscopy are feasible and may offer benefits in high-risk patients. Further studies to document the actual safety and clinical value of our procedure are warranted.

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Percutaneous lead extraction and venous recanalisation using spectranetics tight rail: A single centre experience

Indian Pacing and Electrophysiology Journal ◽

10.1016/j.ipej.2016.10.003 ◽

2016 ◽

Vol 16 (4) ◽

pp. 134-138 ◽

Cited By ~ 2

Author(s):

V. Sawhney ◽

A. Breitenstein ◽

S. Sporton ◽

M. Dhinoja

Keyword(s):

Lead Extraction ◽

Single Centre ◽

Single Centre Experience

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136-54: Incidence and outcomes of repeat lead extraction procedures: A 14 year, single-centre experience

EP Europace ◽

10.1093/europace/18.suppl_1.i103c ◽

2016 ◽

Vol 18 (suppl_1) ◽

pp. i103-i103

Author(s):

Simon Claridge ◽

Jonathan Johnson ◽

Christopher Rajkumar ◽

Tom Jackson ◽

Jonathan Behar ◽

...

Keyword(s):

Lead Extraction ◽

Single Centre ◽

Extraction Procedures ◽

Single Centre Experience

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Lead-Related Infective Endocarditis in Latvia: A Single Centre Experience

Medicina ◽

10.3390/medicina55090566 ◽

2019 ◽

Vol 55 (9) ◽

pp. 566

Author(s):

Nesterovics ◽

Stradins ◽

Kalejs ◽

Ansabergs ◽

...

Keyword(s):

Infective Endocarditis ◽

Electronic Devices ◽

Positive Culture ◽

Major Complication ◽

Heart Rhythm ◽

University Hospital ◽

Lead Extraction ◽

Coagulase Negative Staphylococci ◽

Cardiac Implantable Electronic Devices ◽

Common Location

Background and Objectives: Over the last five decades cardiac implantable electronic devices (CIED) have become established as the mainstay for the treatment of permanent bradycardias, chronic heart failure and dangerous heart rhythm disturbances. These devices improve survival and quality of life in many patients. However, infections associated with CIED implantation, particularly lead-related infective endocarditis (LRIE), can offset all benefits and make more harm than good for the patient. To date, there are no other studies in Latvia, addressing patients with lead-related infective endocarditis. The objective of this study was to identify the most common pathogens associated with LRIE and their antimicrobial resistance and to identify possible risk factors of patients who present with LRIE. Materials and Methods: The study was performed retrospectively at Pauls Stradins Clinical University Hospital (PSCUH). The study included patients who were referred to PSCUH due to LRIE for lead extraction. Patients were identified from procedural journals. Information about isolated microorganisms, patient comorbidities and visual diagnostics data was taken from patient records. Results: Forty-nine patients with CIED related infective endocarditis were included in the study, 34 (69.4%) were male, median age of all patients was 65.0 (50.5–73.0) years, median hospital stay was 15.5 (22.0–30.5) days. Successful and complete lead extraction was achieved in all patients. Thirty-two (65.3%) had received antibiotics prior to blood sample. Only in 31 (63.3%) positive culture results were seen. The most common isolated pathogens were Staphylococcus aureus (23.5%) and coagulase negative staphylococci (23.5%). Other bacteria were isolated considerably less often. The atrial lead was most common location for lead vegetations, seen in 50.0% of cases. Five (10.2%) patients have died due to the disease. Conclusions: Lead-related infective endocarditis is a major complication of cardiac implantable electronic devices with considerable morbidity and mortality, which in our study was as high as 10.2%.

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