Comparative durability of pacemaker leads in transvenous lead extraction: An evaluation through bench testing

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Junji Morita MD , Ayako Okada MD, PhD , Fred Kusumoto MD, FHRS , Kentaro Nakamura MD
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引用次数: 0

Abstract

Background

Transvenous lead extraction (TLE) is a less invasive alternative to surgical removal, but leads may break during TLE.

Objective

The purpose of this study was to compare the tensile strength and behavior under stress of leads from different manufacturers during TLE using different extraction techniques.

Methods

Different lead types (Tendril STS, INGEVITY, INGEVITY+, Solia S, and CapSure Fix) were subjected to tensile testing using a testing machine. The leads were tested in up to 3 different configurations: terminal removed, terminal retained, and removal using a snare. Lead durability was assessed by increasing force and measuring elongation and the force required for complete disruption.

Results

The tensile strength of leads varied greatly based on the extraction technique and lead type. The INGEVITY leads showed improved durability when secured with a snare, despite weak performance when the terminal was removed or retained. The INGEVITY+ lead exhibited enhanced durability, particularly when removed using a snare. The Tendril STS lead exhibited the least durability when the terminal was removed but had comparable durability to the Solia S and CapSure Fix leads when the terminal was retained. The Solia S and CapSure Fix leads had consistent higher durability, irrespective of whether or not the terminal was removed.

Conclusion

This study found wide variability of lead behavior among manufacturers and with different extraction techniques. Terminal retention and snare usage enhanced lead durability, suggesting that these techniques should be considered depending on lead type and for leads with longer implantation periods or if higher extraction forces are anticipated.
经静脉铅提取中起搏器导联的比较耐久性:通过台架试验的评估
背景:经静脉铅拔出(TLE)是一种创伤较小的手术切除方法,但在TLE中铅可能断裂。目的本研究的目的是比较不同制造商的引线在使用不同的提取技术时的拉伸强度和应力下的行为。方法采用拉力试验机对不同类型引线(Tendril STS、INGEVITY、INGEVITY+、Solia S、CapSure Fix)进行拉伸试验。引线测试了多达3种不同的配置:终端移除,终端保留,并使用圈套移除。通过增加力和测量伸长率以及完全破坏所需的力来评估铅的耐久性。结果不同拔管方式和拔管类型,引线的抗拉强度差异较大。INGEVITY引线在用圈套固定时表现出更好的耐用性,尽管当终端被移除或保留时性能较差。INGEVITY+铅芯表现出增强的耐用性,特别是当使用圈套去除时。当终端被移除时,Tendril STS引线的耐久性最低,但当终端被保留时,其耐久性与Solia S和CapSure Fix引线相当。无论端子是否被移除,Solia S和CapSure Fix引线都具有更高的耐用性。结论:本研究发现不同制造商和不同提取技术的铅行为存在很大差异。末端保留和陷阱的使用提高了引线的耐久性,这表明这些技术应该根据引线类型和更长的植入周期或更高的拔出力来考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Heart Rhythm O2
Heart Rhythm O2 Cardiology and Cardiovascular Medicine
CiteScore
3.30
自引率
0.00%
发文量
0
审稿时长
52 days
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