Pawel Stefanczyk, Anna Polewczyk, Dorota Nowosielecka*, Lukasz Tulecki, Maria Miszczak-Knecht, Wojciech Jachec, Andrzej Kleinrok, Katarzyna Bieganowska, Andrzej Kutarski
Volume3-Issue3
Dates: Received: 2022-02-28 | Accepted: 2022-03-05 | Published: 2022-03-08
Pages: 221-226
Abstract
Children require often replacement of leads even several times. Repeated extraction in this group nay be challenging. We report the case of a 22-year-old man with the first pacemaker implanted in the first year of life, after Transvenous Lead Extraction procedure (TLE) and implantation of a dual-chamber pacemaker in the age of 12 years, who was admitted to the reference center for repeated TLE and to replace the entire pacing system. The presence of complete venous occlusion, lead strain and strong lead-to-lead adherence with calcified connecting tissue scar effected TLE complicity and needed utility of numerous tools and atypical technique and tricks among of them simultaneous extraction of strongly connected each one leads together via one tool showed to be crucial.
FullText HTML
FullText PDF
DOI: 10.37871/jbres1426
Certificate of Publication

Copyright
© 2022 Stefanczyk P, et al. Distributed under Creative Commons CC-BY 4.0
How to cite this article
Stefanczyk P, Polewczyk A, Nowosielecka D, Tulecki L, Miszczak-Knecht M, Jachec W, Kleinrok A, Bieganowska K, Kutarski A. Lead Extraction and Re-Extractions - Inherent Parts of Permanent Pacing in Children and Young Adults. J Biomed Res Environ Sci. 2022 Mar 08; 3(3): 221-226. doi: 10.37871/jbres1426, Article ID: JBRES1426, Available at: https://www.jelsciences.com/articles/jbres1426.pdf
Subject area(s)
References
- Rausch CM, Hughes BH, Runciman M, Law IH, Bradley DJ, Sujeev M, Duke A, Schaffer M, Collins KK. Axillary versus infraclavicular placement for endocardial heart rhythm devices in patients with pediatric and congenital heart disease. Am J Cardiol. 2010 Dec 1;106(11):1646-1651. doi: 10.1016/j.amjcard.2010.07.025. Epub 2010 Oct 19. PMID: 21094368.
- Silvetti MS, Drago F, Marcora S, Rav L. Outcome of single-chamber, ventricular pacemakers with transvenous leads implanted in children. Europace. 2007;9:894-899. https://tinyurl.com/4abmzdh4
- Fortescue EB, Berul CI, Cecchin F, Walsh EP, Triedman JK, Alexander ME. Patient, procedural, and hardware factors associated with pacemaker lead failures in pediatrics and congenital heart disease. Heart Rhythm. 2004 Jul;1(2):150-159. doi: 10.1016/j.hrthm.2004.02.020. PMID: 15851146.
- Atallah J, Erickson CC, Cecchin F, Dubin AM, Law IH, Cohen MI, Lapage MJ, Cannon BC, Chun TU, Freedenberg V, Gierdalski M, Berul CI; Pediatric and Congenital Electrophysiology Society (PACES). Multi-institutional study of implantable defibrillator lead performance in children and young adults: results of the Pediatric Lead Extractability and Survival Evaluation (PLEASE) study. Circulation. 2013 Jun 18;127(24):2393-2402. doi: 10.1161/CIRCULATIONAHA.112.001120. Epub 2013 May 21. PMID: 23694966.
- Silvetti MS, Drago F, Grutter G, De Santis A, Di Ciommo V, Ravà L. Twenty years of paediatric cardiac pacing: 515 pacemakers and 480 leads implanted in 292 patients. Europace. 2006 Jul;8(7):530-536. doi: 10.1093/europace/eul062. PMID: 16798767.
- Fortescue EB, Berul CI, Cecchin F, Walsh EP, Triedman JK, Alexander ME. Patient, procedural, and hardware factors associated with pacemaker lead failures in pediatrics and congenital heart disease. Heart Rhythm. 2004 Jul;1(2):150-159. doi: 10.1016/j.hrthm.2004.02.020. PMID: 15851146.
- Lotfy W, Hegazy R, AbdElAziz O, Sobhy R, Hasanein H, Shaltout F. Permanent cardiac pacing in pediatric patients. Pediatr Cardiol. 2013 Feb;34(2):273-280. doi: 10.1007/s00246-012-0433-2. Epub 2012 Aug 12. PMID: 22886361.
- Singh HR, Batra AS, Balaji S. Cardiac pacing and defibrillation in children and young adults. Indian Pacing Electrophysiol J. 2013;13:4-13. https://tinyurl.com/2p9axsuu
- McCanta AC, Schaffer MS, Collins KK. Pediatric and adult congenital endocardial lead extraction or abandonment decision (pacelead) survey of lead management. Pacing Clin Electrophysiol. 2011 Dec;34(12):1621-1627. doi: 10.1111/j.1540-8159.2011.03226.x. Epub 2011 Sep 28. PMID: 21955103.
- Suga C, Hayes DL, Hyberger LK, Lloyd MA. Is there an adverse outcome from abandoned pacing leads? J Interv Card Electrophysiol. 2000 Oct;4(3):493-499. doi: 10.1023/a:1009860514724. PMID: 11046188.
- Silvetti MS, Drago F. Outcome of young patients with abandoned, nonfunctional endocardial leads. Pacing Clin Electrophysiol. 2008;31:473-479. https://tinyurl.com/4txxst2f
- Roux JF, Pagé P, Dubuc M, Thibault B, Guerra PG, Macle L, Roy D, Talajic M, Khairy P. Laser lead extraction: predictors of success and complications. Pacing Clin Electrophysiol. 2007 Feb;30(2):214-220. doi: 10.1111/j.1540-8159.2007.00652.x. PMID: 17338718.
- Lau YR, Gillette PC, Buckles DS, Zeigler VL. Actuarial survival of transvenous pacing leads in a pediatric population. Pacing Clin Electrophysiol. 1993 Jul;16(7 Pt 1):1363-1367. doi: 10.1111/j.1540-8159.1993.tb01729.x. PMID: 7689200.
- Spittell PC, Vlietstra RE, Hayes DL, Higano ST. Venous obstruction due to permanent transvenous pacemaker electrodes: treatment with percutaneous transluminal balloon venoplasty. Pacing Clin Electrophysiol. 1990 Mar;13(3):271-274. doi: 10.1111/j.1540-8159.1990.tb02040.x. PMID: 1690399.
- Figa FH, McCrindle BW, Bigras JL, Hamilton RM, Gow RM. Risk factors for venous obstruction in children with transvenous pacing leads. Pacing Clin Electrophysiol. 1997 Aug;20(8 Pt 1):1902-9. doi: 10.1111/j.1540-8159.1997.tb03594.x. PMID: 9272526.
- Böhm A, Pintér A, Duray G, Lehoczky D, Dudás G, Tomcsányi I, Préda I. Complications due to abandoned noninfected pacemaker leads. Pacing Clin Electrophysiol. 2001 Dec;24(12):1721-1724. doi: 10.1046/j.1460-9592.2001.01721.x. PMID: 11817804.
- Jacheć W, Polewczyk A, Segreti L, Bongiorni MG, Kutarski A. To abandon or not to abandon: Late consequences of pacing and ICD lead abandonment. Pacing Clin Electrophysiol. 2019 Jul;42(7):1006-1017. doi: 10.1111/pace.13715. Epub 2019 May 13. PMID: 31046136.
- Grazia Bongiorni M, Dagres N, Estner H, Pison L, Todd D, Blomstrom-Lundqvist C; Scientific Initiative Committee, European Heart Rhythm Association. Management of malfunctioning and recalled pacemaker and defibrillator leads: Results of the european heart rhythm association survey. Europace. 2014 Nov;16(11):1674-1678. doi: 10.1093/europace/euu302. PMID: 25344962.
- Hussein AA, Tarakji KG, Martin DO, Gadre A, Fraser T, Kim A, Brunner MP, Barakat AF, Saliba WI, Kanj M, Baranowski B, Cantillon D, Niebauer M, Callahan T, Dresing T, Lindsay BD, Gordon S, Wilkoff BL, Wazni OM. Cardiac implantable electronic device infections: added complexity and suboptimal outcomes with previously abandoned leads. JACC Clin Electrophysiol. 2017 Jan;3(1):1-9. doi: 10.1016/j.jacep.2016.06.009. Epub 2016 Sep 7. PMID: 29759687.
- Segreti L, Rinaldi CA, Claridge S, Svendsen JH, Blomstrom-Lundqvist C, Auricchio A, Butter C, Dagres N, Deharo JC, Maggioni AP, Kutarski A, Kennergren C, Laroche C, Kempa M, Magnani A, Casteigt B, Bongiorni MG; ELECTRa Investigators. Procedural outcomes associated with transvenous lead extraction in patients with abandoned leads: an ESC-EHRA ELECTRa (European Lead Extraction ConTRolled) Registry Sub-Analysis. Europace. 2019 Apr 1;21(4):645-654. doi: 10.1093/europace/euy307. PMID: 30624715.
- Cooper JM, Stephenson EA, Berul CI, Walsh EP, Epstein LM. Implantable cardioverter defibrillator lead complications and laser extraction in children and young adults with congenital heart disease: Implications for implantation and management. J Cardiovasc Electrophysiol. 2003;14:344-349. https://tinyurl.com/39yhpmmt
- Friedman RA1, Van Zandt H, Collins E, LeGras M, Perry J. Lead extraction in young patients with and without congenital heart disease using the subclavian approach. Pacing Clin Electrophysiol. 1996;19:778-783. https://tinyurl.com/46c4xzww
- Moak JP, Freedenberg V, Ramwell C, Skeete A. Effectiveness of excimer laser-assisted pacing and ICD lead extraction in children and young adults. Pacing Clin Electrophysiol. 2006 May;29(5):461-466. doi: 10.1111/j.1540-8159.2006.00376.x. PMID: 16689839.
- Zartner PA, Wiebe W, Toussaint-Goetz N, Schneider MB. Lead removal in young patients in view of lifelong pacing. Europace. 2010;12:714-718. https://tinyurl.com/yc57yeuv
- McCanta AC, Tanel RE, Gralla J, Runciman DM, Collins KK. The fate of nontargeted endocardial leads during the extraction of one or more targeted leads in pediatrics and congenital heart disease. Pacing Clin Electrophysiol. 2014 Jan;37(1):104-108. doi: 10.1111/pace.12282. Epub 2013 Oct 25. PMID: 24164671.
- Cecchin F, Atallah J, Walsh EP, Triedman JK, Alexander ME, Berul CI. Lead extraction in pediatric and congenital heart disease patients. Circ Arrhythm Electrophysiol. 2010 Oct;3(5):437-444. doi: 10.1161/CIRCEP.110.957324. Epub 2010 Aug 20. PMID: 20729392.
- Fu H, Ho G, Yang M, Huang X, Fender EA, Mulpuru S, Asirvatham R, Pretorius VG, Friedman PA, Birgersdotter-Green U, Cha YM. Outcomes of repeated transvenous lead extraction. Pacing Clin Electrophysiol. 2018 Oct;41(10):1321-1328. doi: 10.1111/pace.13464. Epub 2018 Aug 23. PMID: 30058073.
- Saeed O, Gupta A, Gross JN, Palma EC. Rate of cardiovascular implantable electronic device (CIED) re-extraction after recurrent infection. Pacing Clin Electrophysiol. 2014 Aug;37(8):963-968. doi: 10.1111/pace.12407. Epub 2014 Apr 26. PMID: 24766634.
- Polewczyk M, Tomków K, Tułecki Ł, Polewczyk A, Mlynarczyk K, Kutarski A. Abandoned pacing lead - a trap and a source of following technical complications during transvenous lead extraction. Heart Beat. 2018;3:90-92. https://tinyurl.com/5e54a4y3
- Nowosielecka D, Polewczyk A, Jacheć W, Kleinrok A, Tułecki Ł, Kutarski A. Transesophageal echocardiography for the monitoring of transvenous lead extraction. Kardiol Pol. 2020 Dec 23;78(12):1206-1214. doi: 10.33963/KP.15651. Epub 2020 Oct 16. PMID: 33078921.
- Jacheć W, Polewczyk A, Polewczyk M, Tomasik A, Kutarski A. Transvenous Lead Extraction SAFeTY Score for Risk Stratification and Proper Patient Selection for Removal Procedures Using Mechanical Tools. J Clin Med. 2020 Jan 28;9(2):361. doi: 10.3390/jcm9020361. PMID: 32013032; PMCID: PMC7073714.
- Jacheć W, Polewczyk A, Polewczyk M, Tomasik A, Janion M, Kutarski A. Risk factors predicting complications of transvenous lead extraction. Biomed Res Int. 2018;8796704. https://tinyurl.com/yn8k9h77
- Kutarski A, Czajkowski M, Pietura R, Obszanski B, Jachec W, Polewczyk M, Mlynarczyk K, Grabowski M, Opolski G. Effectiveness, safety, and long-term outcomes of non-powered mechanical sheaths for transvenous lead extraction. Europace. 2018;20:1324-1333. https://tinyurl.com/bdzj43c4
- Gould J, Sidhu BS, Porter B, Sieniewicz BJ, Teall T, Williams SE, Shetty A, Bosco P, Blauth C, Gill J, Rinaldi CA. Prolonged lead dwell time and lead burden predict bailout transfemoral lead extraction. Pacing Clin Electrophysiol. 2019 Oct;42(10):1355-1364. doi: 10.1111/pace.13791. Epub 2019 Sep 5. PMID: 31433064.
- Zucchelli G, Di Cori A, Segreti L, Laroche C, Blomstrom-Lundqvist C, Kutarski A, Regoli F, Butter C, Defaye P, Pasquié JL, Auricchio A, Maggioni AP, Bongiorni MG; ELECTRa Investigators. Major cardiac and vascular complications after transvenous lead extraction: acute outcome and predictive factors from the ESC-EHRA ELECTRa (European Lead Extraction ConTRolled) registry. Europace. 2019 May 1;21(5):771-780. doi: 10.1093/europace/euy300. PMID: 30590520.