New-onset pericardial effusion during transvenous lead extraction: incidence, causative mechanisms, and associated factors

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
François RegoliAngelo Auricchio

Abstract

Pericardial effusion (PE) may occur during the lead extraction procedure (TLE). Little is known about the incidence, causes, and predictors of this complication. From January 2009 to October 2016, TLE was attempted for 297 leads in 212 patients (age 69.3 ± 12.9 years, 169 male, BMI 27.2 ± 9.9 m²/kg, LVEF 43.4 ± 24.6%) for lead dysfunction (62.7%), upgrade (16.0%), infection (14.2%), or other (7.0%) indications. TLE was performed under general anesthesia with continuous invasive arterial blood pressure and transesophageal echocardiography (TEE) monitoring. For lead removal, the mechanical approach was first attempted, followed by the laser-assisted technique when needed. Severity of PE was defined by the presence of hemodynamically significant PE > 10 mm at TEE. Clinical success was achieved for 292 leads (98.3%). New-onset PE was observed in 14 patients (6.6%) [mild entity in 7 patients (3.3%) and severe in 7 (3.3%)]. In these latter patients, intra-procedural management included surgery (n = 3), pericardiocentesis (n = 2), or a conservative approach (n = 2). Right ventricular (RV) site lesions were treated with a simple fluid infusion. Laceration of the superior vena cava and other vessels resulted in rescue surgery. Lesions o...Continue Reading

References

Dec 1, 2009·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Robert G HauserLinda M Kallinen
Dec 15, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·J C DeharoUNKNOWN European Heart Rhythm Association
May 25, 2012·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Maria Grazia BongiorniUNKNOWN Scientific Initiative Committee, European Heart Rhythm Association
Aug 15, 2013·Herzschrittmachertherapie & Elektrophysiologie·Maria Grazia BongiorniAngelo Auricchio
Jan 22, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Michael P BrunnerBruce L Wilkoff
Jan 23, 2014·Journal of Cardiovascular Electrophysiology·Sandeep K GoyalJeffrey Rottman
Apr 24, 2014·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Fernando ArribasKatja Zeppenfeld
Oct 15, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·François RegoliAngelo Auricchio
Dec 17, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Maria Grazia BongiorniEzio Soldati
Sep 19, 2017·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Fred M KusumotoOussama Wazni

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Citations

Dec 28, 2018·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Giulio ZucchelliUNKNOWN ELECTRa Investigators

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