Lead Extraction Is Preferred for Lead Revisions and System Upgrades: When Less Is More

作者：Melanie Maytin, Laurence Mark Epstein · 发表于：Circulation Arrhythmia and Electrophysiology · 年份：2010 · DOI：10.1161/circep.110.954107 · 被引用次数：126 · 研究领域：Cardiac pacing and defibrillation studies、Cardiac Arrhythmias and Treatments、Cardiac electrophysiology and arrhythmias

C ardiovascular implantable electronic device (CIED) use has increased exponentially during the past decade, 1-3 with Ͼ4.5 million active devices and Ͼ1 million new leads implanted annually. 4,5With expanded CIED use and indications for device therapy, observed complications have increased in parallel. 6 -14 The occurrence of more frequent device system revisions for complications, 6 -8 system upgrades, [15][16][17] and/or lead malfunction 9 -13 and longer patient life expectancies have mandated a paradigm shift toward premeditated lead management strategies from implant to removal or replacement.Consequently, clinicians increasingly are faced with the challenging choice of extraction or abandonment of sterile, superfluous leads.The decision is difficult and highly controversial, 4,18 -26 with limited rigorous evidence and passionate arguments on either side.