To Extract or not To Extract? Navigating Lead Failure in Cardiac Devices.

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Cardiology Reports Pub Date : 2025-09-17 DOI:10.1007/s11886-025-02282-z

Eric W Mills, Dingxin Qin, Theofanie Mela

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Abstract

Purpose of review: Lead failure in cardiac implantable electronic devices (CIEDs) presents a critical challenge in clinical electrophysiology. These failures can result in inappropriate therapies, ineffective pacing, and even life-threatening outcomes. Despite technological advances in device design, transvenous leads remain an important source of complications.

Recent findings: Novel developments in lead extraction strategies including pre-procedure risk prediction instruments, estimation of short-term mortality after lead extraction procedure, use of new technologies including shock-wave lithotripsy to facilitate disruption of intravascular calcium, cardioneural ablation to avoid need for reimplantation of cardiac devices, and the use of leadless pacemaker/defibrillator systems followed transvenous extraction are discussed. This review explores the underlying mechanisms of lead failure, highlighting notable cases such as the Riata and Fidelis recalls, and discusses the complex decision-making process surrounding lead abandonment, extraction, or replacement.

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抽取还是不抽取？心脏装置导航导联失效。

综述目的：心脏植入式电子装置（CIEDs）的导联衰竭是临床电生理学的一个重要挑战。这些失败可能导致不适当的治疗，无效的起搏，甚至危及生命的结果。尽管设备设计技术进步，经静脉导联仍然是并发症的重要来源。最近的发现：本文讨论了拔铅策略的新进展，包括术前风险预测仪器、拔铅后短期死亡率的估计、冲击波碎石术等新技术的使用，以促进血管内钙的破坏、心神经消融以避免心脏装置的重新植入，以及经静脉拔铅后使用无铅起搏器/除颤器系统。这篇综述探讨了铅失效的潜在机制，重点介绍了Riata和Fidelis召回等著名案例，并讨论了围绕铅的废弃、提取或替换的复杂决策过程。

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

Current Cardiology Reports CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

6.20

自引率

2.70%

发文量

209

期刊介绍： The aim of this journal is to provide timely perspectives from experts on current advances in cardiovascular medicine. We also seek to provide reviews that highlight the most important recently published papers selected from the wealth of available cardiovascular literature. We accomplish this aim by appointing key authorities in major subject areas across the discipline. Section editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.