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  • 1
    Electronic Resource
    Electronic Resource
    Venous Occlusion of the Access Vein in Patients Referred for Lead Extraction: (2003)
    350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Futura Publishing, Inc.
    Pacing and clinical electrophysiology 26 (2003), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aim of this study was to determine the effect of patient and lead characteristics on occlusion of the access vein in pacemaker and ICD patients. Contrast venography of the access vein was obtained in 89 patients (17 patients with an ICD) scheduled for lead extraction. The indication for extraction was infection in 57 patients (systemic infection in 9) and lead malfunction in 32 patients. In 6 of the 89 patients, leads were introduced in both the right and left subpectoral area, resulting in a total of 95 venous entry sites. In 22 of these entry sites one lead was present, in 61 two leads, in 11 three, and in 1 four leads. The vessel patency was graded open or occluded. Occlusion of the subclavian vein occurred in four (13%) patients with lead malfunction versus 18 (32%) patients with infection (P = 0.07). In patients with systemic infection, 5 of 9 showed venous occlusion (P = 0.01 when compared to patients with malfunction, odds ratio 8.75, 95% confidence interval 1.21–64.11). Considered per entry site, the incidence of occlusion was 7 of 22 with one lead present, 17 of 61 with two leads, 0 of 11 with three leads, and 0 of 1 with four leads (P = 0.13). No patient had a superior vena caval occlusion. Patients with systemic infection have an increased risk of occlusion of the access vein. On the contrary, the study found no support for the concept that the risk of venous occlusion increases with a higher number of leads present. (PACE 2003; 26:1649–1652)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2003.t01-1-00247.x
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  • 2
    Electronic Resource
    Electronic Resource
    The Effect of Anodal Stimulation on V-V Timing at Varying V-V Intervals (2005)
    350 Main Street , Malden , MA 02148-5018 , USA and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Pacing and clinical electrophysiology 28 (2005), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We studied the effect of anodal capture at the ring electrode of the right ventricular (RV) lead on interventricular (V-V) timing during biventricular (BiV) pacing, in which left ventricular (LV) pacing was preceding RV pacing. The V-V interval was programmed from 80 to 4 ms (LV first) in the LV unipolar (LV tip—generator can) followed by the LV tip-RV ring pacing configuration. In the LV unipolar configuration, V-V programming leads to a continuous change in morphology of the QRS complex according to a change in collision of both activation fronts. When using the LV tip-RV ring configuration with anodal capture at the RV ring electrode no change in QRS morphology was recorded varying the V-V interval from 80 to 60 and 40 ms. However, at V-V intervals between 20 and 4 ms a change in morphology of the QRS complex was recorded, which was due to additional cathodal stimulation of the RV tip electrode during RV stimulation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.2005.00185.x
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  • 3
    Electronic Resource
    Electronic Resource
    Successful Implantation of a Coronary Sinus Lead After Stenting of a Coronary Vein Stenosis (2003)
    350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Futura Publishing, Inc.
    Pacing and clinical electrophysiology 26 (2003), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Dislodgment of the coronary sinus lead was observed in a 79-year-old patient 8 months after implantation of a biventricular pacing system. A severe stenosis in the posterolateral branch, in which the lead was previously positioned, prohibited reinsertion of the lead. Because no other branches with adequate anatomy for lead insertion were available in the targeted area, the stenosis was dilated and stented. Subsequently, the left ventricular lead could be reimplanted in the same vessel. (PACE 2003; 26:1904–1906)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2003.00289.x
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  • 4
    Electronic Resource
    Electronic Resource
    Learning Curve Characteristics of Pacing Lead Extraction with a Laser Sheath (1998)
    Oxford, UK : Blackwell Publishing Ltd
    Pacing and clinical electrophysiology 21 (1998), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The learning curve characteristics of lead extraction with a laser sheath were examined in 19 patients. Forty-two leads were removed: five leads were removed by traction alone, five required a femoral approach as a primary procedure and a laser sheath was used in 32 lead extraction attempts. Primary laser success was achieved in 26 attempts (81 %). A femoral approach was successfully applied as a back-up procedure in five of the failures. Overall, 26% of the leads were removed by the femoral approach. The overall success rate was 98% (41 of 42 leads). No variables related to the patients, leads, or extraction techniques were significantly related to failure of laser sheath extraction. There was a distinct learning curve with all but one failure occurring in the first half of our cases. All failures occurred with leads implanted from the right subclavian vein. In four, a sharply angled curve at the subclavian vein-superior vena cava junction could not be passed with the laser sheath. The ability to smooth this curve improved the results during the learning curve. All procedures were performed in the operating room for safety reasons. This precaution was lifesaving in a case of acute tamponade after laser extraction of an atrial lead. In another case the left internal mammary artery was torn after laser sheath extraction, causing the formation of a false aneurysm. New pacing leads were introduced in nine patients during the same procedure. The mean procedure time was 255 ± 110 min. reflecting the complexity of these procedures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.1998.tb01172.x
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  • 5
    Electronic Resource
    Electronic Resource
    Cure of Interfascicular Reentrant Ventricular Tachycardia by Ablation of the Anterior Fascicle of the Left Bundle Branch (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiovascular electrophysiology 6 (1995), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Ablation of Interfascicular Reentrant Tachycardia. Introduction: Fascicular reentrant ventricular tachycardia (VT) using the anterior fascicle of the left bundle anterogradely is rare and may produce identical QRS morphology during sinus rhythm and VT. Catheter ablation of this type of VT has not been described in detail. Methods and Results: In a postinfarct patient with dilated left ventricle and recurrent VT (showing a QRS configuration of right bundle branch, left posterior fascicular block), endocardial recordings from the His-Purkinje system showed that VT was due to interfascicular reentry. Induction of VT occurred after progressive retrograde conduction delay on increasing the prematurity of the extrastimulus. Anterograde conduction occurred exclusively over the left anterior fascicle, which caused identical QRS morphology during sinus rhythm and VT. During VT, the left posterior fascicle was used retrogradely. The usual target for bundle branch reentry ablation, the right bundle, did not participate in the reentrant circuit. While performing left ventricular endocardial mapping, VT was interrupted when positioning the catheter on the left anterior fascicle, and “reversed” nonsustained bundle branch reentry occurred with anterograde conduction over the posterior fascicle and retrograde conduction over the anterior fascicle. Ablation of conduction in the anterior fascicle led to cure of the VT. Conclusion: Interfascicular reentrant VT with right bundle branch block, right-axis QRS configuration can be cured by catheter ablation of anterior fascicle conduction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8167.1995.tb00421.x
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  • 6
    Electronic Resource
    Electronic Resource
    Lead Extraction Via the Femoral Artery of a Left Ventricular Pacing Lead Inserted in the Subclavian Artery (2003)
    350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Futura Publishing, Inc.
    Pacing and clinical electrophysiology 26 (2003), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We describe the extraction of a pacing lead via the femoral artery 5 months after it was inadvertently introduced through the right subclavian artery and positioned in the left ventricle. The lead was dislocated from the myocardium by traction from the subpectoral area and subsequently removed with a retriever inserted through the femoral artery in order to minimize the risk of cerebral embolization and bleeding at the entry site. Bleeding was controlled at the subclavian artery entry site by temporary inflation of a balloon catheter inserted through the brachial artery, and at the insertion site of the retriever in the femoral artery with a closure device. (PACE 2003; 26[Pt. I]:1544–1547)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2003.t01-1-00225.x
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  • 7
    Electronic Resource
    Electronic Resource
    Implantation of a Biventricular Pacing System in a Patient with a Coronary Sinus Not Communicating with the Right Atrium (2003)
    350 Main Street , Malden , MA 02148-5018 , U.S.A . : Blackwell Publishing
    Pacing and clinical electrophysiology 26 (2003), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Intubation of the coronary sinus failed during implantation of a biventricular pacing system. An angiogram of the left coronary artery showed in the venous phase a coronary sinus not communicating with the right atrium. The coronary sinus was draining into a persistent left superior vena cava communicating with the left subclavian vein. The coronary sinus lead was successfully implanted through the persistent left superior vena cava, whereas the atrial and ventricular leads were implanted through the right superior vena cava in a conventional way. (PACE 2003; 26:1294–1296)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2003.t01-1-00184.x
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  • 8
    Electronic Resource
    Electronic Resource
    Extraction of Pacemaker and Implantable Cardioverter Defibrillator Leads: Patient and Lead Characteristics in Relation to the Requirement of Extraction Tools (2002)
    Oxford, UK : Blackwell Futura Publishing, Inc.
    Pacing and clinical electrophysiology 25 (2002), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: BRACKE, F., et al.: Extraction of Pacemaker and Implantable Cardioverter Defibrillator Leads: Patient and Lead Characteristics in Relation to the Requirement of Extraction Tools. Effective tools for extraction of pacemaker and ICD leads have been developed in the past decennium. This study investigated the necessity of using these tools in addition to direct traction in relation to patient and lead characteristics. The study encompasses first attempts at extraction of consecutive pacemaker and ICD leads from the subpectoral area. A stepwise extraction protocol was used with traction first (directly or with a locking stylet) followed by laser sheath extraction if not successful. The indication, patient age, time from implant, fixation mechanism, location, and insertion site of the leads were studied in relation to the outcome of traction. A total of 145 leads in 83 patients were extracted. Leads were implanted for 71 ± 61 months. Indication for extraction was infection in 96 leads and malfunction in 49 leads. There were 90 ventricular leads including 16 ICD leads. Forty-nine (34%) leads were extracted with traction; in 96 (66%) leads a laser sheath was necessary. All leads implanted for 〈 6 months could be removed with traction alone. In a multivariate logistic regression model, time from implant was the main factor determining success of traction (P 〈 0.001), but in case of infection the success rate increased (P = 0.004). In conclusion, time from implant is the decisive factor to judge the potential efficacy of lead extraction with direct traction. If leads are implanted for 6 months, the availability of additional extraction tools is necessary when lead extraction is considered. In addition to time from implant, infected leads have a better chance to be removed with traction although it is a much weaker predictor.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2002.01037.x
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  • 9
    Electronic Resource
    Electronic Resource
    Cardiac Stimulation Caused by Biogalvanic Current During Pacemaker Implantation (2002)
    Oxford, UK : Blackwell Futura Publishing, Inc.
    Pacing and clinical electrophysiology 25 (2002), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: VAN GELDER, B.M., et al.: Cardiac Stimulation Caused by Biogalvanic Current During Pacemaker Implantation. After lead positioning during implantation of a biventricular pacing system intermittent ventricular simulation was observed. There was no pacemaker connected to any of the leads, but ventricular capture could be provoked by an intermittent contact between the lead stylet, which was still partially inserted, and a self-retaining retractor. The same phenomenon was observed from the atrial lead.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2002.00998.x
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  • 10
    Electronic Resource
    Electronic Resource
    Pacemaker-Mediated Tachycardia in a Biventricular Pacing System (2001)
    Oxford, UK : Blackwell Futura Publishing, Inc.
    Pacing and clinical electrophysiology 24 (2001), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: VAN GELDER, B.M., et al.; Pacemaker-Mediated Tachycardia in a Biventricular Pacing System. A 63-year-old man with chronic atrial fibrillation and heart failure had a biventricular pacing system implanted. The pulse generator was a standard DDDR pacemaker, using the atrial channel for the right ventricular lead and the ventricular channel for the left ventricular lead. During final adjustment of the pacing parameters, a pacemaker tachycardia triggered by T wave oversensing from the right ventricular lead was recorded.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2001.01819.x
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