Smith Macy C, Love Charles J
Division of Cardiovascular Medicine, the Ohio State University Medical Center Columbus, Ohio, USA.
Pacing Clin Electrophysiol. 2008 Jun;31(6):736-52. doi: 10.1111/j.1540-8159.2008.01079.x.
The emergence of pacing and implantable cardioverter-defibrillator (ICD) systems, along with expanding indications of these devices (e.g., cardiac resynchronization therapy and sudden cardiac death prevention), increasing infection rates, and device recalls have created the need for removing and upgrading these systems due to various reasons. Removing the pulse generator of a system is generally uncomplicated. Chronically implanted transvenous leads, however, adhere to the venous endothelium and endocardial tissues over time due to fibrosis. Removal of such leads can be a significantly complex procedure requiring tools and techniques that free the lead at fibrotic binding sites. In this article, the state-of-the-art tools and techniques that provide a systematic approach to consistently and safely extract these devices will be reviewed.
起搏系统和植入式心脏复律除颤器（ICD）系统的出现，以及这些设备适应证的不断扩大（如心脏再同步治疗和心脏性猝死预防）、感染率上升和设备召回，导致出于各种原因需要移除和升级这些系统。移除系统的脉冲发生器通常并不复杂。然而，长期植入的经静脉导线会随着时间的推移因纤维化而附着于静脉内皮和心内膜组织。移除此类导线可能是一个非常复杂的过程，需要使用工具和技术来松解导线在纤维化结合部位的附着。在本文中，将对提供系统方法以持续、安全地取出这些设备的最新工具和技术进行综述。
