@Article{Polewczyk2016,
journal="Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej",
issn="1734-9338",
volume="12",
number="4",
year="2016",
title="Leads dislodged into the pulmonary vascular bed in patients with cardiac implantable electronic devices",
abstract=" Introduction : Spontaneous lead dislodgement into the pulmonary circulation is a rare complication of permanent pacing with unproven harmfulness and an indication of controversial class for transvenous lead extraction (TLE).   Aim:  To assess TLE safety in patients with leads dislodged into the pulmonary artery.   Material and methods:  A retrospective analysis of a 9-year-old database of transvenous lead extraction procedures comprising 1767 TLEs was carried out, including a group of 19 (1.1%) patients with leads dislodged into the pulmonary artery (LDPA).   Results:  Under univariate analysis the factors that increased the likelihood of the presence of an electrode in the pulmonary artery were mean lead dwelling time (increase of risk by 9% per year), total number of leads in the heart before TLE (increase of risk by 66% for one lead) and the number of abandoned leads (increase of risk by 119%). The presence of LDPA was associated with frequent occurrence of intracardiac lead abrasion (increase by 316%) and isolated lead-related infective endocarditis (LRIE) (increase by 500%). There were no statistically significant differences in clinical (p = 0.3), procedural (p = 0.94) or radiological (p = 0.31) success rates in compared (LDPA and non-LDPA) groups. Long-term mortality after TLE was comparable in both groups.   Conclusions : As the effectiveness and safety of TLE in patients with LDPA are comparable to those in standard TLE procedures, in our opinion, such patients should be considered TLE candidates.",
author="Polewczyk, Maciej
and Jacheć, Wojciech
and Polewczyk, Aneta M.
and Polewczyk, Anna
and Czajkowski, Marek
and Kutarski, Andrzej",
pages="348--354",
doi="10.5114/aic.2016.63636",
url="http://dx.doi.org/10.5114/aic.2016.63636"
}