Proietti Riccardo, Lombardi Leonida, Quaglia Carlo, Sagone Antonio
Cardiac Electrophysiology Laboratory Luigi Sacco Hospital Milano.
Indian Pacing Electrophysiol J. 2011 Sep;11(5):145-8. Epub 2011 Oct 2.
There is a general consensus that once a part of an implanted cardiac device becomes infected, it is usually impossible to cure the infection without completely removing all prosthetic material from the body. Consequently the Heart Rhythm Society (HRS) included the pocket infection or erosion as a class I indication for pacemaker lead exctraction. However, the procedure still carries a high risk of life-threatening complications due to fibrotic attachments between leads, veins, valves or other endocardial structures, notwithstanding specific tools and techniques that have been developed to assist the lead removal, preventing tissue laceration.
人们普遍认为,一旦植入式心脏设备的某一部分发生感染,如果不从体内完全清除所有假体材料,通常就无法治愈感染。因此,心律协会(HRS)将囊袋感染或糜烂列为起搏器导线拔除的I类适应症。然而,尽管已经开发出特定的工具和技术来辅助导线拔除,防止组织撕裂,但由于导线、静脉、瓣膜或其他心内膜结构之间的纤维化粘连,该手术仍具有发生危及生命并发症的高风险。