Lead Management is More Than Just Extraction

Wed, 9/17/08 - 3:34pm
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Author(s):

Laurence M. Epstein, MD
Brigham and Women’s Hospital
Harvard Medical School
Chief,Arrhythmia Service
Cardiovascular Division
Brigham and Women's Hospital
Boston, Massachusetts

Many factors have led to a dramatic expansion in the implantation of cardiac rhythm management devices such as pacemakers (PCM), implantable defibrillators (ICD) and cardiac resynchronization therapy devices (CRT). This includes an aging population, expanded indications for ICD therapy and the role of CRT in the management of heart failure.^1-4

Therefore, a higher percentage of patients have implanted devices. While usually functioning without issues, physicians must be aware of potential device-related complications. This includes even those physicians not specifically following “the device.” In addition, those physicians responsible for “following” cardiac rhythm management devices must understand the management of these complications. Transvenous lead-related issues can include dislodgement, malfunction, infection or venous occlusion. Properly managing these issues can be critically important and even lifesaving for these patients. ^5,6 The case presented here represents a failure of proper lead management, resulting in over a decade-long saga for the patient involved.

Case History

References:

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