Lead management

ESC CardioMed ◽  
2018 ◽  
pp. 2002-2005
Author(s):  
Jean Claude Deharo
Keyword(s):  
Present Status ◽  
Medical Management ◽  
Lead Extraction ◽  
Huge Number ◽  
Implantation Techniques ◽  
Lead Management ◽  
Lead Technology

With the huge number of pacemaker and defibrillator leads implanted worldwide, the term ‘lead management’ has been launched to cover the proper knowledge of lead technology and implantation techniques related to lead integrity and potential extraction, as well as the implementation of lead extraction strategies and methods. The interest of the cardiological community for these topics has probably been reinforced by recent well-publicized lead performance concerns, but also by the general perception that, in our patients, lead-related problems, including infections, lead redundancy, and venous issues, are a major matter of concern. This chapter discusses the technological aspects related to lead performance, the medical management of lead-related issues, and the present status of lead extraction.

scholarly journals Transvenous lead extraction procedures in women based on ESC-EHRA EORP European Lead Extraction ConTRolled ELECTRa registry: is female sex a predictor of complications?

EP Europace ◽  
2019 ◽  
Author(s):  
Anna Polewczyk ◽  
Christopher A Rinaldi ◽  
Manav Sohal ◽  
Pier-Giorgio Golzio ◽  
Simon Claridge ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Success ◽  
Signs And Symptoms ◽  
Venous Occlusion ◽  
Lead Extraction ◽  
Blood Cell Count ◽  
Female Sex ◽  
Major Complications ◽  
Lead Management ◽  
Post Hoc

Abstract Aims Female sex is considered an independent risk factor of transvenous leads extraction (TLE) procedure. The aim of the study was to evaluate the effectiveness of TLE in women compared with men. Methods and results A post hoc analysis of risk factors and effectiveness of TLE in women and men included in the ESC-EHRA EORP ELECTRa registry was conducted. The rate of major complications was 1.96% in women vs. 0.71% in men; P = 0.0025. The number of leads was higher in men (mean 1.89 vs. 1.71; P < 0.0001) with higher number of abandoned leads in women (46.04% vs. 34.82%; P < 0.0001). Risk factors of TLE differed between the sexes, of which the major were: signs and symptoms of venous occlusion [odds ratio (OR) 3.730, confidence interval (CI) 1.401–9.934; P = 0.0084], cumulative leads dwell time (OR 1.044, CI 1.024–1.065; P < 0.001), number of generator replacements (OR 1.029, CI 1.005–1.054; P = 0.0184) in females and the number of leads (OR 6.053, CI 2.422–15.129; P = 0.0001), use of powered sheaths (OR 2.742, CI 1.404–5.355; P = 0.0031), and white blood cell count (OR 1.138, CI 1.069–1.212; P < 0.001) in males. Individual radiological and clinical success of TLE was 96.29% and 98.14% in women compared with 98.03% and 99.21% in men (P = 0.0046 and 0.0098). Conclusion The efficacy of TLE was lower in females than males, with a higher rate of periprocedural major complications. The reasons for this difference are probably related to disparities in risk factors in women, including more pronounced leads adherence to the walls of the veins and myocardium. Lead management may be key to the effectiveness of TLE in females.

scholarly journals Numerical Modeling of Vascular Stresses During Lead Extraction: Subclavian vs. Femoral

2020 ◽  
Author(s):  
Mostafa Toloui ◽  
Mark Marshall ◽  
Pierce Vatterott ◽  
Peter Zhang ◽  
Ryan Lahm ◽  
...  
Keyword(s):  
Femoral Vein ◽  
High Stress ◽  
Wall Stress ◽  
Extraction Methods ◽  
Lead Extraction ◽  
Vein Wall ◽  
Femoral Approach ◽  
Stress Levels ◽  
Lead Management ◽  
The Individual

Abstract Transvenous lead extraction is a critical and growing technique used to treat patients with chronically implanted pacemakers and defibrillators. This procedure is commonly executed via the subclavian vein or the femoral vein. Some physicians’ experiences indicate that the femoral approach results in fewer vascular tears. This study is aimed to present a physics-based comparative assessment of intravenous mechanical stresses for chronic lead management between the two approaches. Finite Element (FE) modeling is employed to quantify the vascular stress distributions. A full 3-D model including veins, heart, fibrotic scar regions and the lead was created to simulate the different lead extraction methods. Results: (1) highest stresses are generally in the vicinity of SVC lead attachments; (2) femoral approach results in a ∼uniform distribution of stress over the scar while the subclavian approach leads to patches of concentrated high stress; (3) 2–3 times higher maximum vascular stress during subclavian; (4) insignificant maximum stress at the apex for both; (5) inverse variation of stress levels with: (i) branch-to-scar distance for SVC method; and (ii)vein wall thickness in both methods. (6) lower stress levels for scars with longer attachment lengths. The importance and effectiveness of mechanical stress analysis in risk analysis for chronic lead management is illustrated. Overall, the localized intravascular wall stress is meaningfully higher for subclavian vs. femoral extraction with same SVC shear force. This may help explain the higher rate of SVC tears when extracting from the left subclavian approach. The individual anatomy (e.g. vascular angles) is a key factor in the resulting stress and this understanding may be critical when choosing an extraction approach and future lead design.

scholarly journals A review of current approaches to pacing in children with atrioventricular blocks

2020 ◽  
Vol 35 (3) ◽  
pp. 14-31
Author(s):  
B. N. Dambaev ◽  
O. Yu. Dzhaffarova ◽  
L. I. Svintsova ◽  
I. V. Plotnikova ◽  
A. V. Smorgon ◽  
...  
Keyword(s):  
Heart Defects ◽  
Pediatric Population ◽  
The Body ◽  
Lead Extraction ◽  
Physical Parameters ◽  
Cardiac Stimulation ◽  
Advantages And Disadvantages ◽  
Permanent Pacing ◽  
Implantation Techniques ◽  
High Level

Pacing is currently the main method of treatment in children with life-threatening bradyarrhythmias. The high-grade atrioventricular block remains the main indication for permanent pacing in children. The factors that determine the specificity of device implantation in the pediatric population are as follows: anthropometric data of a child and their compliance with the size of a pacemaker and the electrodes, the need for long-term (lifelong) cardiac stimulation and multiple replacements of a pacemaker, high level of child’s activity, changes in the physical parameters of the body over time (the need for implantation of the leads “with reserve” and their replacement), and, in some cases, the presence of concomitant congenital heart defects, especially, with intracardiac shunts. One of the controversial issues in pediatric cardiac stimulation is choosing a method of implantation (epicardial or endocardial). According to recent reports, the epicardial lead implantation techniques are increasingly being used because the transvenous pacemakers are associated with more serious complications and due to the capability to choose hemodynamically optimal stimulation zone in epicardial technique to prevent pacemaker-induced dyssynchrony. This approach allows to ultimately postpone the implantation of the endocardial stimulation system, administration of which is associated with the problem of endovascular lead extraction in children, the problem, which has not been resolved not only in Russia but also worldwide. This review article discusses recent literature on the use of permanent pacing in children, including the advantages and disadvantages of using the endocardial and epicardial pacemaker systems as well as various methods of implantation and pacemaker modes most often used in pediatric practice.

scholarly journals Lead Management as a Modern Internet Technology of Customer Management

2019 ◽  
Vol 4 (2) ◽  
pp. 221-228
Author(s):  
Валерия Брежнева ◽  
Valeria Brezhneva
Keyword(s):  
Economic Effect ◽  
Management Development ◽  
Internet Marketing ◽  
Internet Technology ◽  
Customer Management ◽  
The Internet ◽  
Internet Technologies ◽  
Modern Business ◽  
Lead Management ◽  
Lead Technology

The paper features lead technology, or lead management, in Internet marketing. The research objective was to identify the essence and prospects of lead management development. The author offers an algorithm of actions that can help to achieve the planned sales effect. A content analysis of publications, author’s own observation, and sociological methods helped to identify the high importance of Internet marketing in modern conditions. Competition in the market of industrial goods is increasing, as is the speed of Internet search. In addition, more and more companies duplicate their activities on the Internet. Meanwhile, the powerful development of Internet technologies has triggered problems in the Internet promotion of products and services. Due to the growing number of network users, the struggle for potential buyers is as acute in the Internet as in the real world. Moreover, a large number of entrepreneurs underestimate Internet marketing as a channel of product promotion and thus lose a market share. As a result, there is a growing need to improve Internet technologies for customer management, their number, and demand. The author believes lead management to be a perfect technology for that purpose. The article describes the main conceptual approaches to the essence of leads, their types, features of their production, generation and conversion, algorithms of sequential actions for the formation of leads, and customer management, formulated the methodology of lead management. These technologies can result in a substantial base of loyal customers in Russian business. Lead management is becoming an objective reality of modern business and significantly increases the economic effect of Russian companies.

Contemporary pacemaker and ICD lead management: techniques for lead extraction

2012 ◽  
Vol 10 (7) ◽  
pp. 875-887 ◽  
Author(s):  
Malini Madhavan ◽  
Matthew J Swale ◽  
Joseph J Gard ◽  
David L Hayes ◽  
Samuel J Asirvatham
Keyword(s):  
Lead Extraction ◽  
Management Techniques ◽  
Lead Management

Lead Management and Lead Extraction

2018 ◽  
Vol 10 (1) ◽  
pp. 127-136 ◽  
Author(s):  
Charles J. Love
Keyword(s):  
Lead Extraction ◽  
Lead Management

A short review and Present Status of ZnO Nanoparticle Formation by Ion Implantation Combined with Thermal Oxidation

2005 ◽  
Vol 908 ◽  
Author(s):  
Hiroshi Amekura ◽  
Oleg A Plaksin ◽  
Naoki Umeda ◽  
Yoshihiko Takeda ◽  
Naoki Kishimoto ◽  
...  
Keyword(s):  
Thin Film ◽  
Zinc Oxide ◽  
Ion Implantation ◽  
Thermal Oxidation ◽  
Present Status ◽  
Short Review ◽  
Zno Nanoparticle ◽  
Zno Nanostructures ◽  
Depth Profiles ◽  
Implantation Techniques

AbstractRecently many groups have started studies of formation of zinc-oxide (ZnO) nanoparticle (NP) in transparent insulators, such as silica glass, sapphire, etc, using ion implantation techniques. In the early half of this article, we shortly review recent activities of ZnO NP formation using ion implantation combined with thermal oxidation. Some groups succeeded but the others did not. Even if they succeeded in the formation of ZnO nanostructures, one reported that they were in the shape of thin film and another reported the NP form. Based on our recent experimental results, we point out the importance of the oxidation temperature and the peculiar shapes and depth profiles of ZnO formed.

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