Objective: To present an intravascular countertraction technique of lead extraction for treatment of refractory infection after pacemaker implantation- Methods : Eighteen patients (14 men and 4 women , mean age 56 ...
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Objective: To present an intravascular countertraction technique of lead extraction for treatment of refractory infection after pacemaker implantation- Methods : Eighteen patients (14 men and 4 women , mean age 56 ±13 years) with 28 leads were presented for lead extraction , because of refractory pacemaker pocket infection and erosion- Eleven atrial and seventeen ventricular leads had been implanted for 5-4 ±4-2 years- Alocking stylet was secured atthe distal electrode by counterclockwise rotation to reinforce the lead and facilitate traction ,and telescoping dilator sheaths were used to free the lead from adhesions in the venous system- Results :Twenty fourleads were completely removed and 2 partially removed ,the distal electrodes ofthe latter 2 were detached during extraction and retained in the hepatic vein and subclavian vein ,respectively- The other 2 leads in one patientfailed to be extracted , which were finally taken out by surgical thoracotomy- Afollow up of 11 ±7 months ,the infection was controlled in all patients- Conclusion : With appropriate precautions and patient selection , intravascular countertraction technique allows successful extraction of up to nearly 90 % of permanent pacemakerleads with a relatively low incidence of complications- The extraction ofinfected lead is an effective method for treating refractory infection of pacemaker implantation-
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