Defibrillator leads

Platiaum and its alloys are also used as biomedical electrodes, eg, platiaum—indium wires for permanent and temporary pacemaker leads and defibrillator leads. Electrophysiology catheters, which contain platinum electrodes and marker bands, have been used to map the electrical pathways of the heart so that appropriate treatment, such as a pacemaker, can be prescribed. [Pg.174]

Defibrillation lead employing electrodes fabricated from woven carbon fibers 5..3,36,2.54 1994 Brennen. Williams. Gabler... [Pg.58]

FIGURE I5.I Schematic representation of a dual-chamber ICD. The generator is implanted in the pectoral region. The defibrillation lead (lower) is in the rightventricle, where it is fixed by a helix at the distal (far) end of the lead. The atrial lead (upper) is secured by flexible tines in the right atrial appendage. (Reproduced with permission of Medtronic, Inc.)... [Pg.230]

H. M. Haqqani and H. G. Mond. The implantable cardioverter-defibrillator lead Principles, progress, and promises. Pacing Clin Electrophysiol, 32(10) 1336-1353, October 2009. [Pg.242]

Structure, Function, and Clinical Aspects of Pacemaker and Defibrillator Leads... [Pg.3]

Fig 1 22 Boston Scientific Endotak quadripolar Reliance G implantable cardioverter-defibrillator lead. Two expanded polytetrafluoroethylene (ePTFE or Gore-Tex) jackets black arrows) cover the shock coils to prevent tissue ingrowth (courtesy of Boston Scientific)... [Pg.15]

Fig. 1.23 Two implantable cardioverter-defibrillator lead-body designs. Coaxial multiluminal (b)...

In 2007, an alert was published about an increased incidence of perforation at the apex of the RV in patients with St. Jude Riata defibrillation lead. The complication was probably linked to increased rigidity of the catheter, caused by the reduced body size. A further large independent review in 4,273 Riata implants showed an incidence of perforation of 0.33% [22]. This was interpreted as not being associated with the lead Riata itself but to the use of a very small defibrillation... [Pg.19]

The instruments necessary for overcoming these complications are prevention and treatment. The first is related to durability and reliability of pacing/defibrillating leads and the second to their extractability profile. Both issues apply to each component of a pacing/defibrillating lead. [Pg.20]

Fig 1.30 Insulation fracture of the pacing and sensing connector of an implantable cardioverter-defibrillator lead... [Pg.21]

Fig 1 33 Tenacious adhesion of superior vena cava along the proximal coil of an implantable cardioverter-defibrillator lead with a free-floating filar coil design. Note coil despiralization in the proximal end as a consequence of lead extraction... [Pg.22]

Fig. 1.34 Different methods of covering implantable cardioverter-defibrillator lead coils from different companies (courtesy of St. Jude Medical, Boston Scientific, and Medtronic)...

Fig 1 37 Old and new generations of implantable cardioverter-defibrillator leads in terms of dimensions and iso-diametric design (courtesy of St Jude Medical, Boston Scientific, Medtronic, SorinGroup, and Biotronik)... [Pg.24]

As we know, adherences on a pacing/ defibrillating lead are present not only at the tip but frequently along its entire course. For this reason, the isodia-metric or nonisodiametric design is an important issue, not only in regard to the tip region, but to the entire lead (Fig. 1.37). [Pg.24]

To approach an extraction procedure with more consciousness, it is important to be aware of the complications related to human body response after implantation of a pacing or defibrillating lead [46]. When a transvenous permanent lead is implanted, it stays in close contact with some points of the venous endothelium and endocardium. At these points, the lead may be responsible of chronic traumatism on the endothelium/endocardi-um, causing an inflammatory response of the vessel or endocardial wall, with thrombus formation and subsequent scarring [47-49]. [Pg.28]

Fig 1 41 Section of interventricular septum from a patient who underwent cardiac transplantation 676 days after implantable cardioverter-defibrillator lead implantation and 7 days after last defibrillator shock (a). Right ventricular surface of interventricular septum (R) is at the top and left ventricular surface (L) at bottom. Characteristic fibroelastic tissue encircles the lead curved arrow). Trichrome-stained section of tissue (b) band of fibroelastic tissue curved arrow) encircles lead (L), and beneath, in myocardium, lies fibrous connective tissue F). Area of confluent fibrous connective tissue immediately adjacent to lead also extends into surrounding myocardium, forming radial pattern of interstitial fibrosis arrows), suggesting that shocks have caused lines of electrical injury (courtesy [51])... [Pg.29]

WilkoffBE, BelottPH, Love CJ et al (2005) Improved extraction of ePTEE and medical adhesive modified defibrillation leads from the coronary sinus and great cardiac vein. Pacing Clin Electrophysiol 28(3) 205-211... [Pg.33]

Hauser RG, Cannom D, Hayes DL et al (2002) Long-term structural failure of coaxial polyurethane implantable cardioverter defibrillator leads. Pacing Clin Electrophysiol 25(6) 879-882... [Pg.33]

Krahn AD, Champagne J, Healey JS et al (2008) Outcome of the Eidelis implantable cardioverter-defibrillator lead advisory a report from the Canadian Heart Rhythm Society Device Advisory Committee. Heart Rhythm 5(5) 639-642... [Pg.33]

Ellenbogen KA, Wood MA, Shepard RK et al (2003) Detection and management of an implantable cardioverter defibrillator lead failure incidence and clinical implications. J Am Coll Cardiol 41(l) 73-80... [Pg.33]

MagneyJE, Flynn DM, Parsons JAetal (1993) Anatomical mechanisms explaining damage to pacemaker leads defibrillator leads and failure of central venous catheters adjacent to the sternoclavicular joint. Pacing Clin Electrophysiol 16(3 Pt 1) 445 57... [Pg.33]

Kleemann T, Becker T, Doenges K et al (2007) Annual rate of transvenous defibrillation lead defects in implantable cardioverter-defibrillators over a period of >10 years. Circulation 115(19) 2474-2480... [Pg.34]

Epstein AE, KayGN, Plumb VJetal(1998) Gross and microscopic pathological changes associated with nonthoracotomy implantable defibrillator leads. Circulation 98(15) 1517-1524... [Pg.34]

Sticherling C, Chough SP, Baker RL et al (2001) Prevalence of central venous occlusion in patients with chronic defibrillator leads. Am Heart J 141(5) 813-816... [Pg.34]

Lead removal is removal of a pacing or defibrillator lead using any technique. It includes two completely different procedures lead explant and lead extraction. Lead explant is the removal of a lead using simple traction techniques, which is usually possible for leads implanted for less than 1 year. Lead extraction is removal of a lead implanted for more than 1 year or that requires the assistance of specialized equipment in order to be removed. Lead extraction is by far the more complex procedure. As it carries some risks for the patient, clear indications, expertly trained personnel, adequate tools, and appropriate environment and facilities are mandatory for its safe removal [1, 2]. [Pg.35]

Love CJ, Wilkoff BL, Byrd CL et al (2000) Recommendations for extraction of chronically implanted transvenous pacing and defibrillator leads indications, facilities, training. Pacing Clin Electrophysiol 23(4) 544-551... [Pg.45]

Del Rio A, Anguera I, Miro JM et al (2003) Surgical treatment of pacemaker and defibrillator lead endocarditis. Impact of electrode lead extraction on outcome. Chest 124 1451-1459... [Pg.46]

Lakkireddy DR, Verma A, Wilkoff BL (2005) Current concepts in intravascular pacemaker and defibrillator lead extraction. In Wang, Paul J (ed) New arrhythmia technologies. Gerald V. Naccarelli, Michael R, Rosen NA, Mark Estes III, David L. Hayes, David E. Haines (co-eds). Black-well-Futura Publishing, Malden pp 124-133... [Pg.46]

Pfitzner P, Trappe HJ (1998) Oversensing in a cardiac defibrillator system caused by interaction between two endocardial defibrillation leads in the right ventricle. Pacing Clin Electrophysiol 21 764-768... [Pg.47]

Bracke F, Meijer A, Van Gelder B (2002) Extraction of pacemaker and implantable cardioverter defibrillator leads patient and lead characteristics in relation to the requirement of extraction tools. Pacing and Clin Electrophysiol 25 1037-1040... [Pg.56]

Bongiomi MG, Soldati E, Zucchelli G et al (2008) Transvenous removal of pacing and implantable cardiac defibrillating leads using single sheath mechanical dilatation and multiple venous approaches high success rate and safety in more than 2000 leads. Eur Heart J 29 2886-2893... [Pg.56]

Lead explant manipulation of a pacing or defibrillator lead so that the lead exits the vasculature via the implant vein using tools typically supplied for lead implant, with the addition of manual traction for a lead that has been implanted for less than 1 year. [Pg.57]

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