Preprocedural computed tomography before cardiac implanted electronic device lead extraction: Indication, technique, and approach to interpretation. (27th January 2020)

• Record Type: Journal Article
• Authors: Lewis, Robert K.; Ehieli, Wendy L.; Hegland, Donald D.; Pokorney, Sean D.; Chalian, Hamid; Iranmanesh, Reggy; Hurwitz Koweek, Lynne M.; Piccini, Jonathan P.
• Is Part Of: Journal of cardiovascular electrophysiology. Volume 31:Number 3(2020)
• Page Start: 723
• Page End: 732
• Publication Date: 2020-01-27
• Subjects: computed tomography -- imaging -- implantable cardioverter defibrillator -- lead extraction -- pacemaker; Blood vessels -- Physiology -- Periodicals; Electrophysiology -- Periodicals; Heart -- Physiology -- Periodicals; 612.1
• DOI: 10.1111/jce.14353
• Languages: English
• ISSNs: 1045-3873

Abstract

Abstract: Cardiac implantable electronic devices (CIEDs) frequently need to be extracted due to infection, hardware failure, and other causes. The extraction of the CIED is typically performed using percutaneous methods. While these procedures are mostly performed without incident there is a small risk of significant complications. Dedicated imaging pre‐CEID removal to include the central veins and heart with multidetector computed tomography (MDCT) can be utilized to evaluate the lead course and termination, the integrity of the central veins and cardiac chambers, and identify potential complications that may alter the lead extraction procedure as well as reimplantation of subsequent leads. Indications for preprocedural imaging, the technique of dedicated preprocedural lead extraction MDCT, and the approach to the interpretation of the images is discussed in this review.