Department of Electrocardiology, Institute of Cardiology, Jagiellonian Universtity Collegium Medicum, John Paul II Hospital, Krakow, Poland.
Kardiol Pol. 2010 Aug;68(8):884-90.
Leads used for low-voltage and high-voltage therapy delivered by implantable cardioverter-defibrillators (ICD) differ from low-voltage pacemaker (PM) leads in their diameter and complexity of structure. Although there are reports showing that the extraction of ICD leads may be hazardous, due to firm adhesions to the vascular and chamber walls of high-voltage therapy coils, clinical evidence suggests that such procedures are safe.
To compare the efficacy and safety of transvenous extraction of ICD and PM leads in patients enrolled in a single tertiary centre.
We compared the results of lead extraction procedures in 345 patients with PM and in 79 patients submitted for the lead removal including at least one ICD lead. We analysed ingrown leads i.e. over 12 month-old PM leads and over 6 month-old ICD leads, which were removed using Cook's device.
Patients in the two groups differed significantly in age and gender. The ICD systems were significantly younger, less complex (fewer leads per patient) and presented higher efficacy of extraction and fewer technical difficulties. The number of major complications was similar to the encountered during extraction of PM leads. However, minor complications were significantly more frequent in the ICD group.
植入式心脏复律除颤器（ICD）用于低电压和高电压治疗的导联与低电压起搏器（PM）导联在直径和结构复杂性上有所不同。尽管有报道称提取 ICD 导联可能存在危险，因为它们与高电压治疗线圈的血管和心室壁紧密粘连，但临床证据表明这些操作是安全的。
比较单中心纳入的 PM 和 ICD 患者经静脉提取导联的疗效和安全性。
我们比较了 345 例 PM 患者和 79 例因至少 1 根 ICD 导联而接受导联移除的患者的导联提取结果。我们分析了植入超过 12 个月的 PM 导联和植入超过 6 个月的 ICD 导联（使用 Cook 装置移除）。
两组患者在年龄和性别上存在显著差异。ICD 系统明显更年轻，结构更简单（每位患者的导联数量更少），提取成功率更高，技术难度更小。主要并发症的数量与 PM 导联提取时遇到的相似。然而，ICD 组的轻微并发症明显更为频繁。
