Minimal Invasive Left Ventricular Lead Repositioning is Safe and Effective in Distal Left Ventricular Lead Positions

IstvÁn Osztheimer, Szabolcs SzilÁgyi, Zsuzsanna Pongor, E. Zima, Levente MolnÁr, TamÁs Tahin, B. Merkely, L. Gellér

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Treatment of left ventricular electrode dislocation and phrenic nerve stimulation remains an issue in the era of new electrode designs. Methods: Safety and efficacy of minimal invasive lead repositioning and pocket opening reposition procedures were evaluated between December 2005 and December 2012 at our center. Minimal invasive method was developed and widely utilized at our center to treat phrenic nerve stimulation. The distally positioned left ventricular lead is looped around by a deflectable catheter in the right atrium introduced from the femoral vein access and then pulled back. Coronary stent implantation was used afterwards for lead stabilization in some patients. Results: 42 minimal invasive and 48 electrode repositions with pacemaker pocket opening were performed at 77 patients for left ventricular lead problems. Minimal invasive reposition could be carried out successfully in 69% of (29 patients) cases. Note that in 14.3% of the cases (six patients) minimal invasive procedures were acutely unsuccessful and crossover was necessary. In 16.6% of the cases (seven patients) lead issues were noted later during follow-up. Opening of the pocket could be carried out successfully in 81.2% (39 patients) and was unsuccessful acutely in 6.25% (three patients). Repeated dislocation was noticed, 12.5%, in this group (six patients). Complication during minimal invasive procedures was electrode injury in one case. Pocket openings were associated with several complications: atrial fibrillation, pericardial effusion, fever, hematoma, and right ventricular electrode dislodgement. Conclusion: Minimal invasive procedure—as the first line approach—is safe and feasible for left ventricular electrode repositioning in selected cases.

Original languageEnglish
Pages (from-to)488-493
Number of pages6
JournalPACE - Pacing and Clinical Electrophysiology
Volume40
Issue number5
DOIs
Publication statusPublished - May 1 2017

Fingerprint

Electrodes
Phrenic Nerve
Femoral Vein
Pericardial Effusion
Lead
Heart Atria
Hematoma
Atrial Fibrillation
Stents
Fever
Catheters
Safety
Wounds and Injuries
Therapeutics

Keywords

  • device-associated complications
  • electrode dislodgement
  • left ventricular lead
  • minimal invasive

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Minimal Invasive Left Ventricular Lead Repositioning is Safe and Effective in Distal Left Ventricular Lead Positions. / Osztheimer, IstvÁn; SzilÁgyi, Szabolcs; Pongor, Zsuzsanna; Zima, E.; MolnÁr, Levente; Tahin, TamÁs; Merkely, B.; Gellér, L.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 40, No. 5, 01.05.2017, p. 488-493.

Research output: Contribution to journalArticle

Osztheimer, IstvÁn ; SzilÁgyi, Szabolcs ; Pongor, Zsuzsanna ; Zima, E. ; MolnÁr, Levente ; Tahin, TamÁs ; Merkely, B. ; Gellér, L. / Minimal Invasive Left Ventricular Lead Repositioning is Safe and Effective in Distal Left Ventricular Lead Positions. In: PACE - Pacing and Clinical Electrophysiology. 2017 ; Vol. 40, No. 5. pp. 488-493.
@article{28b32433a934413cba1c50760d7ddabf,
title = "Minimal Invasive Left Ventricular Lead Repositioning is Safe and Effective in Distal Left Ventricular Lead Positions",
abstract = "Background: Treatment of left ventricular electrode dislocation and phrenic nerve stimulation remains an issue in the era of new electrode designs. Methods: Safety and efficacy of minimal invasive lead repositioning and pocket opening reposition procedures were evaluated between December 2005 and December 2012 at our center. Minimal invasive method was developed and widely utilized at our center to treat phrenic nerve stimulation. The distally positioned left ventricular lead is looped around by a deflectable catheter in the right atrium introduced from the femoral vein access and then pulled back. Coronary stent implantation was used afterwards for lead stabilization in some patients. Results: 42 minimal invasive and 48 electrode repositions with pacemaker pocket opening were performed at 77 patients for left ventricular lead problems. Minimal invasive reposition could be carried out successfully in 69{\%} of (29 patients) cases. Note that in 14.3{\%} of the cases (six patients) minimal invasive procedures were acutely unsuccessful and crossover was necessary. In 16.6{\%} of the cases (seven patients) lead issues were noted later during follow-up. Opening of the pocket could be carried out successfully in 81.2{\%} (39 patients) and was unsuccessful acutely in 6.25{\%} (three patients). Repeated dislocation was noticed, 12.5{\%}, in this group (six patients). Complication during minimal invasive procedures was electrode injury in one case. Pocket openings were associated with several complications: atrial fibrillation, pericardial effusion, fever, hematoma, and right ventricular electrode dislodgement. Conclusion: Minimal invasive procedure—as the first line approach—is safe and feasible for left ventricular electrode repositioning in selected cases.",
keywords = "device-associated complications, electrode dislodgement, left ventricular lead, minimal invasive",
author = "Istv{\'A}n Osztheimer and Szabolcs Szil{\'A}gyi and Zsuzsanna Pongor and E. Zima and Levente Moln{\'A}r and Tam{\'A}s Tahin and B. Merkely and L. Gell{\'e}r",
year = "2017",
month = "5",
day = "1",
doi = "10.1111/pace.13068",
language = "English",
volume = "40",
pages = "488--493",
journal = "PACE - Pacing and Clinical Electrophysiology",
issn = "0147-8389",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Minimal Invasive Left Ventricular Lead Repositioning is Safe and Effective in Distal Left Ventricular Lead Positions

AU - Osztheimer, IstvÁn

AU - SzilÁgyi, Szabolcs

AU - Pongor, Zsuzsanna

AU - Zima, E.

AU - MolnÁr, Levente

AU - Tahin, TamÁs

AU - Merkely, B.

AU - Gellér, L.

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Background: Treatment of left ventricular electrode dislocation and phrenic nerve stimulation remains an issue in the era of new electrode designs. Methods: Safety and efficacy of minimal invasive lead repositioning and pocket opening reposition procedures were evaluated between December 2005 and December 2012 at our center. Minimal invasive method was developed and widely utilized at our center to treat phrenic nerve stimulation. The distally positioned left ventricular lead is looped around by a deflectable catheter in the right atrium introduced from the femoral vein access and then pulled back. Coronary stent implantation was used afterwards for lead stabilization in some patients. Results: 42 minimal invasive and 48 electrode repositions with pacemaker pocket opening were performed at 77 patients for left ventricular lead problems. Minimal invasive reposition could be carried out successfully in 69% of (29 patients) cases. Note that in 14.3% of the cases (six patients) minimal invasive procedures were acutely unsuccessful and crossover was necessary. In 16.6% of the cases (seven patients) lead issues were noted later during follow-up. Opening of the pocket could be carried out successfully in 81.2% (39 patients) and was unsuccessful acutely in 6.25% (three patients). Repeated dislocation was noticed, 12.5%, in this group (six patients). Complication during minimal invasive procedures was electrode injury in one case. Pocket openings were associated with several complications: atrial fibrillation, pericardial effusion, fever, hematoma, and right ventricular electrode dislodgement. Conclusion: Minimal invasive procedure—as the first line approach—is safe and feasible for left ventricular electrode repositioning in selected cases.

AB - Background: Treatment of left ventricular electrode dislocation and phrenic nerve stimulation remains an issue in the era of new electrode designs. Methods: Safety and efficacy of minimal invasive lead repositioning and pocket opening reposition procedures were evaluated between December 2005 and December 2012 at our center. Minimal invasive method was developed and widely utilized at our center to treat phrenic nerve stimulation. The distally positioned left ventricular lead is looped around by a deflectable catheter in the right atrium introduced from the femoral vein access and then pulled back. Coronary stent implantation was used afterwards for lead stabilization in some patients. Results: 42 minimal invasive and 48 electrode repositions with pacemaker pocket opening were performed at 77 patients for left ventricular lead problems. Minimal invasive reposition could be carried out successfully in 69% of (29 patients) cases. Note that in 14.3% of the cases (six patients) minimal invasive procedures were acutely unsuccessful and crossover was necessary. In 16.6% of the cases (seven patients) lead issues were noted later during follow-up. Opening of the pocket could be carried out successfully in 81.2% (39 patients) and was unsuccessful acutely in 6.25% (three patients). Repeated dislocation was noticed, 12.5%, in this group (six patients). Complication during minimal invasive procedures was electrode injury in one case. Pocket openings were associated with several complications: atrial fibrillation, pericardial effusion, fever, hematoma, and right ventricular electrode dislodgement. Conclusion: Minimal invasive procedure—as the first line approach—is safe and feasible for left ventricular electrode repositioning in selected cases.

KW - device-associated complications

KW - electrode dislodgement

KW - left ventricular lead

KW - minimal invasive

UR - http://www.scopus.com/inward/record.url?scp=85016433880&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85016433880&partnerID=8YFLogxK

U2 - 10.1111/pace.13068

DO - 10.1111/pace.13068

M3 - Article

VL - 40

SP - 488

EP - 493

JO - PACE - Pacing and Clinical Electrophysiology

JF - PACE - Pacing and Clinical Electrophysiology

SN - 0147-8389

IS - 5

ER -