Retraction of device leads may be a risky procedure. We report a case of a patient with a pacemaker pocket infection and two abandoned leads. Locking stylets were introduced in each electrode and both stylets were pulled through the rotating blade wi...
23 May 2022
Transluminal lead extraction (TLE) is a well-established procedure for the removal of damaged or infected pacing systems. Despite its high efficacy, the procedure is associated with significant risks, some of which may contribute to severe life-threa...
The axillary and cephalic veins are commonly utilized for transvenous pacemaker lead access. They typically advance to the heart through the subclavian, brachiocephalic, and superior vena cava veins. Anatomical variations such as a persistent left su...
The number of infections related to cardiac implantable electronic devices (CIEDs) has increased as the number of devices implanted around the world has grown exponentially in recent years. CIED complications can sometimes be difficult to diagnose an...
Remote monitoring of pacemakers decreases patient complications and reduces public health expenses. The transmission of passive real-time electrograms (EGM) has been shown to increase the diagnostic yield, but this may add to the work burden. Passive...
Background: Lead-associated complications and technical issues in patients with cardiac implantable electronic devices are common but underreported in the literature. Methods: All patients undergoing implantation of the Osypka QT-5® ventricular lead...
Lead pacemaker infection is a complication on the rise. An infected oscillating mass attached to the leads (ILV) is a common finding in this setting. Percutaneous extraction of the leads and of the device is the best curative option. However, extract...
Background and Objectives: The number of cardiac pacemakers being used has increased in recent decades, and this increase has led to a rise in device-related complications, requiring percutaneous device extraction. Our aim was to present our single-c...
Background/Objectives: The use of temporary pacemakers is increasing every year. Conventional temporary pacemakers are connected to the myocardium via a passive-fixation lead (temporary pacing with passive fixation leads; TPPF), which compromises the...
Background and Clinical Significance: Early lead failure after dual-chamber pacemaker implantation is rare but clinically significant, particularly when associated with thromboembolic complications. Technical pitfalls at the time of implantation, suc...
22 April 2015
Background: Contrast-guided axillary vein puncture has gained popularity for pacemaker and implantable cardioverter defibrillator (ICD) implantation in adults owing to its low risk profile, and could be an alternative to subclavian vein puncture, whi...
Background and Clinical Significance: Early loss of pacing capture after pacemaker generator replacement is an uncommon but potentially life-threatening event, especially in pacemaker-dependent patients. In this setting, device malfunction is often i...
We report the case of a 76-year-old man who had a dual-chamber pacemaker implanted 17 years before and was initially admitted due to a Campylobacter fetus bacteraemia without any evident source of infection. He was treated by imipenem/cilastatin foll...
A 65-year-old man was admitted as for one month of repetitive dizziness and one episode of syncope. Electrocardiogram showed sinus bradycardia and his Holter monitoring also showed sinus bradycardia with sinus arrest, sino-atrial block and a longest...
Anomalies of the thoracic venous system are rare and usually discovered incidentally, but they become clinically relevant in the case of patients requiring cardiac device implantation. Persistent left superior vena cava is considered the most common...
The human heart’s remarkable vitality necessitates a deep understanding of its mechanics, particularly concerning cardiac device leads. This paper presents advancements in finite element modeling for cardiac leads and 3D heart models, leveragin...
Patients who have an implantable cardiac pacemaker that survive beyond the operational life of the device require replacement surgeries that increase healthcare costs and may possibly introduce post-operative complications such as infection. In this...
During surgical procedures, real-time estimation of the current position of a metal lead within the patient’s body is obtained by radiographic imaging. The inherent opacity of metal objects allows their visualization using X-ray fluoroscopic de...
This article gives an overview on the practical management of device infections of chronically implanted pacemakers and implantable cardioverter- defibrillators. The main feature of such infections is the fact that the implanted materials have direct...
Mycoplasma hominis is a habitual colonizing microorganism of the lower genital tract but can exceptionally be the causal agent of blood culture-negative infective endocarditis (IE). Only 11 cases of this entity have been published to date. The study...
Background/Objectives: Cardiac implantable electronic device (CIED) infections are infrequent but clinically significant, and Latin American—particularly Chilean—data remain scarce. We aimed to describe the clinical and microbiological pr...
When approaching infected lead removal in cardiac device-related infective endocarditis (CDRIE), a surgical consideration for large (>20 mm) vegetations is recommended. We report our experience with the removal of large CDRIE vegetations using the...
Background/Objectives: Twiddler’s syndrome is an uncommon but clinically important complication of implantable cardiac devices, in which generator rotation within the pocket results in lead torsion, lead retraction, and device malfunction. Recu...
Background/Objective: Previous studies have indicated a higher incidence of complications associated with dual-lead devices compared to single-lead devices. This retrospective study aimed to investigate the effect of lead count and other factors on p...
Permanent pacemaker implantation improves survival but can cause tricuspid valve dysfunction in the form of tricuspid regurgitation (TR). The dominant mechanism of pacemaker-mediated TR is lead impingement. This study evaluated the association betwee...
Permanent pacemaker implantation is a low-risk procedure. However, complications may occur at a rate of around 4–8%. We present a case where initial implantation resulted in complications that could have been avoided by meticulous assessment of...
24 December 2022
Background: Upgrading from pacemakers to ICDs and CRTs is a difficult procedure, and often, transvenous lead extraction (TLE) is necessary for venous access. TLE is considered riskier in patients with multiple diseases. We aimed to assess the complex...
Background: In patients requiring dual-chamber pacemaker (DDD) implantation, optimal atrial lead position remains a matter of debate. While most centers prefer implantation in the right atrial appendage position (Non-BB-P), due to a speculated favora...
Background. The inadvertent lead malposition in the left heart (ILMLH) is an under-recognized event, which may complicate the implantation of cardiac electronic devices (CIEDs). Methods. We investigated the clinical conditions associated with ILMLH a...
Tricuspid regurgitation (TR) in patients with transvalvular cardiac implantable electronic device (CIED) leads is increasingly encountered as transcatheter tricuspid valve interventions (TTVI) expand, yet integrated guidance for managing this “...
Indications for cardiac implantable electronic devices (CIEDs) are increasing. Almost one-third of device-related infections are endocarditis. Transvenous lead extraction (TLE) has emerged as an effective and safe approach for treating device-related...
Left bundle branch area pacing (LBBPa) is an innovative technique for physiological pacing. Compared with His bundle pacing, LBBPa provides better pacing thresholds, lower rates of macrodislodgment, and a reliable strategy for cardiac resynchronizati...
Cardiac implantable electronic device (CIED) implants are rising in an older, more co-morbid population. The prevalence of CIED infection ranges from 1–4%. Whilst complete extraction of all transvenous hardware is recommended for infected, erod...
Until recently, left bundle branch area pacing (LBBAp) has mostly been performed using lumen-less fixed screw leads. There are limited data on LBBAp with conventional style-driven extendable screw-in (SDES) leads, particularly data performed by opera...
Background/Objectives: Retained fragments of cardiovascular implantable electronic device (CIED) leads are frequently observed after orthotopic heart transplantation (OHT), but their clinical relevance remains unclear. Methods: We conducted a single-...
Lead extraction, a demanding task. Every year approximately 10,000–15,000 pacemakerand ICD-leads are extracted worldwide with numbers continuing to rise. The increasing need for lead extractions may be explained by the evolution of pacemakerand ICD-i...
(1) Background: Early reintervention increases the risk of infection of cardiac implantable electronic devices (CIEDs). Some operators therefore delay lead repositioning in the case of dislocation by weeks; however, there is no evidence to support th...
Background: Safe discontinuation of pacemaker therapy for vagally mediated bradycardia is a dilemma. The aim of the study was to present the outcomes of a proposed diagnostic and therapeutic process aimed at discontinuing or not restoring pacemaker t...
A five-month-old African jenny was presented with a history of exercise intolerance and syncopal episodes. Severe bradycardic arrhythmia due to a high-grade second-degree atrioventricular (AV) block with progression to complete AV block was diagnosed...
Continuous monitoring of pacemaker activity can provide valuable information to improve patients’ follow-up. Concise information is stored in some types of pacemakers, whereas ECG can provide more detailed information, but requires electrodes a...
Induced pluripotent stem cell (iPSC)-derived biological pacemakers have emerged as an alternative to traditional electronic pacemakers for managing cardiac arrhythmias. While effective, electronic pacemakers face challenges such as device failure, le...
The heart is composed of muscle cells called cardiomyocytes, including a specialized population named pacemaker cells that form the cardiac conduction system (CCS), which is responsible for generating the action potential dictating heart contractions...
Background and Objectives: There is currently no method that can be used for a precise evaluation of pacemaker leads using X-ray images, which could be a valuable add-on in the follow-up of patients. The aim of this paper was to create a simple metho...
Background: The aim of this study is to determine the safety of a locally implemented Standard of Practice (SOP) in patients with cardiac implantable electronic devices (CIEDs). With increasing use of radiotherapy in cancer treatment and the widespre...
Cardiological and oncological patients comprise the majority of patients admitted to the emergency unit with chronic or acute conditions that are the dominant cause of death worldwide. However, electrotherapy and implantable devices (pacemakers and c...
Leadless pacemakers (LPMs) have emerged as an alternative to conventional transvenous pacemakers to eliminate the complications associated with leads and subcutaneous pockets. However, LPMs still present with complications, such as cardiac perforatio...
Left bundle branch block or ventricular paced rhythms can sometimes make acute myocardial ischaemia difficult to diagnose in the 12-lead ECG. Several algorithms for diagnosing ST segment elevation myocardial infarction have been described with differ...
Background and Clinical Significance: Evaluating wide complex rhythms in patients with permanent pacemakers can be a diagnostic challenge, particularly when the rhythm is irregular. While pacemaker-mediated rhythms are typically regular and predictab...
Background: The 2018 United-Network-for-Organ-Sharing (UNOS) allocation-system changes resulted in greater recognition of mechanical circulatory support (MCS), leading to more heart transplantations (HTx) in patients with MCS. We aimed to investigate...
The sinoatrial node (SAN), the primary pacemaker of the heart, consists of a heterogeneous population of specialized cardiac myocytes that can spontaneously produce action potentials, generating the rhythm of the heart and coordinating heart contract...
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