Anesthetic Management of Laser Lead Extraction for Cardiovascular Implantable Electronic Devices. (December 2017)

• Record Type: Journal Article
• Authors: Bhatia, Meena; Safavi-Naeini, Payam; Razavi, Mehdi; Collard, Charles D.; Tolpin, Daniel A.; Anton, James M.
• Is Part Of: Seminars in cardiothoracic and vascular anesthesia. Volume 21:Number 4(2017:Dec.)
• Page Start: 302
• Page End: 311
• Publication Date: 2017-12
• Subjects: catheter-based lead removal -- cardiac anesthesia -- AICD -- pacemaker -- intraoperative TEE; Cardiovascular system -- Surgery -- Methods -- Periodicals; Chest -- Surgery -- Methods -- Periodicals; Anesthesia -- Periodicals; Anesthetics -- Periodicals; Anesthesia -- Periodicals; Anesthetics -- Periodicals; Cardiovascular Surgical Procedures -- methods -- Periodicals; Thoracic Surgical Procedures -- methods -- Periodicals; 617.96
• DOI: 10.1177/1089253217728581
• Languages: English
• ISSNs: 1089-2532

Abstract

Cardiovascular implantable electronic devices (CIEDs) play a significant role in the modern management of cardiovascular disease. CIEDs include implantable pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. These devices improve the quality of life of their recipients and help reduce the incidence of sudden cardiac death. Traditionally, CIEDs have been reliant on the use of transvenous endocardial leads to directly connect with the heart. Over time, these endovascular leads may become endothelialized rendering removal extremely difficult. As the indications for CIEDs expands and with the continuing evolution of these devices, the number of patients requiring explantation for device recall, malfunction, and infection continues to increase. In this manuscript, we review the most common CIEDs, the indications and process of lead removal/device explantation, potential complications associated with the procedure and the anesthetic management of these patients.