Off-label combination of leadless pacemakers and subcutaneous defibrillators in bilateral venous occlusion: a new reimplantation strategy after lead extraction
Abstract Background Subcutaneous implantable cardioverter-defibrillator (S-ICD) and leadless pacemakers (LPM) provide an alternative to transvenous implantable devices. Sometimes, after transvenous (TV) lead extraction, patients show a bilateral venous occlusion, resulting not eligible for TV reimpl...
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| Veröffentlicht in: | European heart journal 2020-11, Vol.41 (Supplement_2) |
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| creator | Di Cori, A Viani, S Tolve, S Zucchelli, G Barletta, V Giannotti Santoro, M Parollo, M Cellamaro, T Branchitta, G Carluccio, M Segreti, L Paperini, L De Lucia, R Soldati, E Bongiorni, M.G |
| description | Abstract
Background
Subcutaneous implantable cardioverter-defibrillator (S-ICD) and leadless pacemakers (LPM) provide an alternative to transvenous implantable devices. Sometimes, after transvenous (TV) lead extraction, patients show a bilateral venous occlusion, resulting not eligible for TV reimplantation.
Purpose
This analysis was designed to provide preliminary data on feasibility and short-term outcome of an hybrid combination (Hyb) of s-ICD plus LPM after TV-ICD explantation, in patients without anatomical transvenous reimplantation options.
Methods
Among 2684 consecutive extracted patients, 31 (1.1%) were reimplanted with a LPM, 66 (2.4%) with a s-ICD and 6 (0.2%) patients with an Hyb combination. Hyb strategy was considered in patients with a pacing plus defibrillating indication, and an anatomical barrier, as bilateral superior venous occlusion or massive bilateral skin erosion.
Results
Hyb patients were old (72±10 years), with a prevalent ischemic disease (4/6) and a reduced ejection fraction (43±16%). Extraction indication was infection in 4 and severe venous occlusion in 2, and included 2 single chamber, 2 dual chamber and 2 biventricular ICD. After extraction, reimplantation timing was 7±6 days, LPM was implanted before and sICD the day after.
LPM reimplantation indication was sinus node dysfunction in 2 and AV block in 4. Implantation duration was 68±23 and fluoroscopy time 9.4±2.3 min. ICD reimplantation indication was primary prevention in 4 and secondary prevention in 2. Implantation duration was 118±10 min. No complications were observed. At 1 year, no complications were observed, including device related cross-talks.
Conclusions
The Hyb strategy is a potential option after TV-ICD explantation in pacemaker dependent patients, when transvenous implantation is not available.
Extraction and Reimplantation Session
Funding Acknowledgement
Type of funding source: None |
| doi_str_mv | 10.1093/ehjci/ehaa946.0826 |
| format | Article |
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Background
Subcutaneous implantable cardioverter-defibrillator (S-ICD) and leadless pacemakers (LPM) provide an alternative to transvenous implantable devices. Sometimes, after transvenous (TV) lead extraction, patients show a bilateral venous occlusion, resulting not eligible for TV reimplantation.
Purpose
This analysis was designed to provide preliminary data on feasibility and short-term outcome of an hybrid combination (Hyb) of s-ICD plus LPM after TV-ICD explantation, in patients without anatomical transvenous reimplantation options.
Methods
Among 2684 consecutive extracted patients, 31 (1.1%) were reimplanted with a LPM, 66 (2.4%) with a s-ICD and 6 (0.2%) patients with an Hyb combination. Hyb strategy was considered in patients with a pacing plus defibrillating indication, and an anatomical barrier, as bilateral superior venous occlusion or massive bilateral skin erosion.
Results
Hyb patients were old (72±10 years), with a prevalent ischemic disease (4/6) and a reduced ejection fraction (43±16%). Extraction indication was infection in 4 and severe venous occlusion in 2, and included 2 single chamber, 2 dual chamber and 2 biventricular ICD. After extraction, reimplantation timing was 7±6 days, LPM was implanted before and sICD the day after.
LPM reimplantation indication was sinus node dysfunction in 2 and AV block in 4. Implantation duration was 68±23 and fluoroscopy time 9.4±2.3 min. ICD reimplantation indication was primary prevention in 4 and secondary prevention in 2. Implantation duration was 118±10 min. No complications were observed. At 1 year, no complications were observed, including device related cross-talks.
Conclusions
The Hyb strategy is a potential option after TV-ICD explantation in pacemaker dependent patients, when transvenous implantation is not available.
Extraction and Reimplantation Session
Funding Acknowledgement
Type of funding source: None</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/ehjci/ehaa946.0826</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European heart journal, 2020-11, Vol.41 (Supplement_2)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,27931,27932</link.rule.ids></links><search><creatorcontrib>Di Cori, A</creatorcontrib><creatorcontrib>Viani, S</creatorcontrib><creatorcontrib>Tolve, S</creatorcontrib><creatorcontrib>Zucchelli, G</creatorcontrib><creatorcontrib>Barletta, V</creatorcontrib><creatorcontrib>Giannotti Santoro, M</creatorcontrib><creatorcontrib>Parollo, M</creatorcontrib><creatorcontrib>Cellamaro, T</creatorcontrib><creatorcontrib>Branchitta, G</creatorcontrib><creatorcontrib>Carluccio, M</creatorcontrib><creatorcontrib>Segreti, L</creatorcontrib><creatorcontrib>Paperini, L</creatorcontrib><creatorcontrib>De Lucia, R</creatorcontrib><creatorcontrib>Soldati, E</creatorcontrib><creatorcontrib>Bongiorni, M.G</creatorcontrib><title>Off-label combination of leadless pacemakers and subcutaneous defibrillators in bilateral venous occlusion: a new reimplantation strategy after lead extraction</title><title>European heart journal</title><description>Abstract
Background
Subcutaneous implantable cardioverter-defibrillator (S-ICD) and leadless pacemakers (LPM) provide an alternative to transvenous implantable devices. Sometimes, after transvenous (TV) lead extraction, patients show a bilateral venous occlusion, resulting not eligible for TV reimplantation.
Purpose
This analysis was designed to provide preliminary data on feasibility and short-term outcome of an hybrid combination (Hyb) of s-ICD plus LPM after TV-ICD explantation, in patients without anatomical transvenous reimplantation options.
Methods
Among 2684 consecutive extracted patients, 31 (1.1%) were reimplanted with a LPM, 66 (2.4%) with a s-ICD and 6 (0.2%) patients with an Hyb combination. Hyb strategy was considered in patients with a pacing plus defibrillating indication, and an anatomical barrier, as bilateral superior venous occlusion or massive bilateral skin erosion.
Results
Hyb patients were old (72±10 years), with a prevalent ischemic disease (4/6) and a reduced ejection fraction (43±16%). Extraction indication was infection in 4 and severe venous occlusion in 2, and included 2 single chamber, 2 dual chamber and 2 biventricular ICD. After extraction, reimplantation timing was 7±6 days, LPM was implanted before and sICD the day after.
LPM reimplantation indication was sinus node dysfunction in 2 and AV block in 4. Implantation duration was 68±23 and fluoroscopy time 9.4±2.3 min. ICD reimplantation indication was primary prevention in 4 and secondary prevention in 2. Implantation duration was 118±10 min. No complications were observed. At 1 year, no complications were observed, including device related cross-talks.
Conclusions
The Hyb strategy is a potential option after TV-ICD explantation in pacemaker dependent patients, when transvenous implantation is not available.
Extraction and Reimplantation Session
Funding Acknowledgement
Type of funding source: None</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNqNUEtOwzAQtRBIlMIFWPkCKbbjuAk7VPGTKnUDErto7IzBxfnIToCehquStD0Am5nRvJ_0CLnmbMFZkd7gx9a4cQIUUi1YLtQJmfFMiKRQMjslM8aLLFEqfzsnFzFuGWO54mpGfjfWJh40emraWrsGetc2tLXUI1QeY6QdGKzhE0Ok0FQ0DtoMPTTYDpFWaJ0Oznvo2xF3DdVuvDGAp1_YTJTWGD_E0fSWAm3wmwZ0deeh6Q9RsQ-j4H1HwY66fSzFn_FpJviSnFnwEa-Oe05eH-5fVk_JevP4vLpbJ4aLTCVSW2Si0NakRYW5RmUlLEWFKWjJRJZKy5aYp7kxHKVYyrzIci6wqICnWtp0TsTB14Q2xoC27IKrIexKzsqp4nJfcXmsuJwqHkXJQdQO3X_4f7q-hnI</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Di Cori, A</creator><creator>Viani, S</creator><creator>Tolve, S</creator><creator>Zucchelli, G</creator><creator>Barletta, V</creator><creator>Giannotti Santoro, M</creator><creator>Parollo, M</creator><creator>Cellamaro, T</creator><creator>Branchitta, G</creator><creator>Carluccio, M</creator><creator>Segreti, L</creator><creator>Paperini, L</creator><creator>De Lucia, R</creator><creator>Soldati, E</creator><creator>Bongiorni, M.G</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20201101</creationdate><title>Off-label combination of leadless pacemakers and subcutaneous defibrillators in bilateral venous occlusion: a new reimplantation strategy after lead extraction</title><author>Di Cori, A ; Viani, S ; Tolve, S ; Zucchelli, G ; Barletta, V ; Giannotti Santoro, M ; Parollo, M ; Cellamaro, T ; Branchitta, G ; Carluccio, M ; Segreti, L ; Paperini, L ; De Lucia, R ; Soldati, E ; Bongiorni, M.G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1256-4bfe029bfc39de8be6f4a72de3ab402534f07e838cc1e4274895812e9da13b4f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Di Cori, A</creatorcontrib><creatorcontrib>Viani, S</creatorcontrib><creatorcontrib>Tolve, S</creatorcontrib><creatorcontrib>Zucchelli, G</creatorcontrib><creatorcontrib>Barletta, V</creatorcontrib><creatorcontrib>Giannotti Santoro, M</creatorcontrib><creatorcontrib>Parollo, M</creatorcontrib><creatorcontrib>Cellamaro, T</creatorcontrib><creatorcontrib>Branchitta, G</creatorcontrib><creatorcontrib>Carluccio, M</creatorcontrib><creatorcontrib>Segreti, L</creatorcontrib><creatorcontrib>Paperini, L</creatorcontrib><creatorcontrib>De Lucia, R</creatorcontrib><creatorcontrib>Soldati, E</creatorcontrib><creatorcontrib>Bongiorni, M.G</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Di Cori, A</au><au>Viani, S</au><au>Tolve, S</au><au>Zucchelli, G</au><au>Barletta, V</au><au>Giannotti Santoro, M</au><au>Parollo, M</au><au>Cellamaro, T</au><au>Branchitta, G</au><au>Carluccio, M</au><au>Segreti, L</au><au>Paperini, L</au><au>De Lucia, R</au><au>Soldati, E</au><au>Bongiorni, M.G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Off-label combination of leadless pacemakers and subcutaneous defibrillators in bilateral venous occlusion: a new reimplantation strategy after lead extraction</atitle><jtitle>European heart journal</jtitle><date>2020-11-01</date><risdate>2020</risdate><volume>41</volume><issue>Supplement_2</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract
Background
Subcutaneous implantable cardioverter-defibrillator (S-ICD) and leadless pacemakers (LPM) provide an alternative to transvenous implantable devices. Sometimes, after transvenous (TV) lead extraction, patients show a bilateral venous occlusion, resulting not eligible for TV reimplantation.
Purpose
This analysis was designed to provide preliminary data on feasibility and short-term outcome of an hybrid combination (Hyb) of s-ICD plus LPM after TV-ICD explantation, in patients without anatomical transvenous reimplantation options.
Methods
Among 2684 consecutive extracted patients, 31 (1.1%) were reimplanted with a LPM, 66 (2.4%) with a s-ICD and 6 (0.2%) patients with an Hyb combination. Hyb strategy was considered in patients with a pacing plus defibrillating indication, and an anatomical barrier, as bilateral superior venous occlusion or massive bilateral skin erosion.
Results
Hyb patients were old (72±10 years), with a prevalent ischemic disease (4/6) and a reduced ejection fraction (43±16%). Extraction indication was infection in 4 and severe venous occlusion in 2, and included 2 single chamber, 2 dual chamber and 2 biventricular ICD. After extraction, reimplantation timing was 7±6 days, LPM was implanted before and sICD the day after.
LPM reimplantation indication was sinus node dysfunction in 2 and AV block in 4. Implantation duration was 68±23 and fluoroscopy time 9.4±2.3 min. ICD reimplantation indication was primary prevention in 4 and secondary prevention in 2. Implantation duration was 118±10 min. No complications were observed. At 1 year, no complications were observed, including device related cross-talks.
Conclusions
The Hyb strategy is a potential option after TV-ICD explantation in pacemaker dependent patients, when transvenous implantation is not available.
Extraction and Reimplantation Session
Funding Acknowledgement
Type of funding source: None</abstract><pub>Oxford University Press</pub><doi>10.1093/ehjci/ehaa946.0826</doi><oa>free_for_read</oa></addata></record> |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| title | Off-label combination of leadless pacemakers and subcutaneous defibrillators in bilateral venous occlusion: a new reimplantation strategy after lead extraction |
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