Heart 2001;85:254-259 ( March )

Review

Pacemaker lead complications: when is extraction appropriate and what can we learn from published data?

F A Bracke, A Meijer, L M van Gelder

Department of Cardiology, Catharina Hospital, PO Box 1350, 5602 ZA Eindhoven, Netherlands

Correspondence to: Dr Bracke f.bracke@skynet.be

Accepted 25 October 2000

The first 150 words of the full text of this article appear below.

	Introduction

Indications for extraction of chronically implanted pacemaker leads have been classified as mandatory, necessary, or discretionary.^1 2 In published reports as well as in clinical practice, most indications cited are non-vital. These indications are often based on clinical judgement, even in published policy statements.³ We therefore reviewed published work on this subject, starting from the Pubmed database, in an attempt to provide an evidence base for the benefits of lead extraction. We begin with a brief overview of the results and complications of current extraction techniques.

	Lead extraction

Recently, comprehensive endovascular techniques have been developed for pacemaker lead extraction.^2 4 5 In the superior vena cava approach, a locking stylet is introduced into the lead and locked close to the distal electrode in order to apply traction directly to the tip.⁶ If gentle traction is not successful, telescoping sheaths can be advanced over the lead to disrupt fibrous binding of the lead to veins or . . . [Full text of this article]

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