Preoperative and Intraoperative Imaging during Transvenous Lead Extraction

Card Electrophysiol Clin. 2024 Dec;16(4):421-434. doi: 10.1016/j.ccep.2024.07.002. Epub 2024 Sep 3.

Abstract

Transvenous lead extraction is performed for device infection, lead failure, or to provide access for additional leads/device upgrade. A patient-centered risk assessment for transvenous lead extraction can be determined using a combination of clinical factors and several imaging modalities. Predicting a complex lead extraction, for example, one that will require powered tools or the use of a femoral approach, is aided by pre-procedural imaging and clinical assessment. Procedural imaging utilizing fluoroscopy, transesophageal echocardiography, and intracardiac echocardiography during an extraction can improve safety and identify complications rapidly.

Keywords: Cardiac computed tomography; Imaging; Intravascular echocardiography; Transesophageal echocardiography; Transvenous lead extraction.

Publication types

  • Review

MeSH terms

  • Defibrillators, Implantable* / adverse effects
  • Device Removal* / methods
  • Echocardiography, Transesophageal
  • Fluoroscopy
  • Humans
  • Pacemaker, Artificial* / adverse effects
  • Preoperative Care / methods