EDITORIAL See Article by Sood et al Jay A. Montgomery, MD Travis D. Richardson, MD George H. Crossley, MD mplantation of cardiovascular implantable electronic devices has increased steadily since their debut some 60 years ago with estimates of 1.2 to 1.4 million I devices implanted annually worldwide. Currently, the vast majority of these car- diovascular implantable electronic devices use leads that provide a direct electrical connection from the pulse generator to cardiac tissue. Inevitably, the incidence of lead extraction has increased concurrently and in recent years has even exceeded the increase in implants. The interaction between the leads and the body is best thought of as a dynamic substrate by virtue of the degree of tissue ingrowth (mak- ing removal more difficult over time), increasing likelihood of venous occlusion with increased dwell time (necessitating lead extraction to gain access for system upgrade or lead replacement), as well as the lead’s position as the electromechani- cal weak link in modern cardiovascular implantable electronic device systems. Current literature on lead extraction safety and outcomes is limited by a few factors. First, lead models change through time, and significant evidence exists that the likelihood of fracture and possibly even extraction-related morbidity and
Circulation: Arrhythmia & Electrophysiology – Wolters Kluwer Health
Published: Feb 1, 2018
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