de Veld Jolien A, Kooiman Kirsten M, Knops Reinoud E
Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, location AMC, The Netherlands.
J Cardiovasc Electrophysiol. 2025 Jan;36(1):298-300. doi: 10.1111/jce.16530. Epub 2024 Dec 18.
The extravascular implantable cardioverter-defibrillator (EV-ICD) was developed to overcome complications associated with transvenous leads while being able to deliver anti-tachycardia pacing (ATP). The lead is implanted in the substernal space, which makes extraction a cautious procedure. We present a case of a 51-year-old women with a successful EV-ICD extraction after a lead dwell time of 4 years, which is the longest reported. The EV-ICD lead was extracted using simple traction after the removal of all adhesions at the xiphoidal site around the lead. We advise to only use extraction tools if the initial attempt is not successful and if no adhesions at the caudal part of the lead are visible anymore, as these tools could also damage the surrounding tissue and the lead.
血管外植入式心脏复律除颤器（EV-ICD）的研发旨在克服经静脉导线相关并发症，同时具备发放抗心动过速起搏（ATP）的能力。该导线植入胸骨后间隙，这使得拔除成为一个谨慎的操作过程。我们报告一例51岁女性患者，在导线植入4年后成功拔除EV-ICD，这是有报道以来最长的导线留置时间。在去除剑突部位导线周围所有粘连后，通过简单牵引拔除了EV-ICD导线。我们建议，只有在初次尝试不成功且导线尾部不再可见粘连时才使用拔除工具，因为这些工具也可能损伤周围组织和导线。
