Literature Review on Pacemaker Lead Dislodgement Complexes: The experience of a Tertiary Center with Eight Cases

Öz

Cardiac pacemakers (CPM) and implantable cardioverter defibrillators (ICD) are indispensable treatment option for the cardiac arrhythmias. The most common complication of pacemaker implantation  is lead dislodgement. We will present eight patients with lead dislodgement about Twiddler, Reel and Ratchet Syndromes. The patients who need lead repositioning for lead dislodgement were collected retrospectively at the Cardiology Clinic of İzmir Katip Celebi University Ataturk Training and Research Hospital from 2016 to 2017. Lead dislodgement is mostly detected at the device interrogation, with worsening insensing voltage or pacing thresholds. The dislodgement of a ventricular lead incidence in a CPM is known as 0.5 to 2.5%. Our center's experience is lower than these rates (<%0.03). Patient education, opening appropriate pocket for  generator size, fixing the sleeves tight enough as required,  hanging battery with a strong suture can be used to avoid lead dislodgement.

Anahtar Kelimeler

• Lead Dislodgement,Cardiac Pacemaker,Complication of Pacemaker Implantation,Implantable Cardioverter Defibrillator,Lead Dislodgement

Kalp Pili Lead Dislokasyonları Kompleksleri Üzerine Literatür İncelemesi: Üçüncü Basamak Bir Merkezin Sekiz Vakalık Deneyimi

Öz

Kardiyak aritmiler için kardiyak kalp pilleri (CPM) ve implante edilebilir kardiyoverter defibrilatörler (ICD) vazgeçilmez bir tedavi seçeneğidir. Kalp pilinin implantasyonunda en sık görülen komplikasyon lead dislokasyonudur. Twiddler, Reel ve Ratchet Sendromları dahilinde leadlerin dislokasyonu ile sekiz hastayı sunacağız. İzmir Katip Çelebi Üniversitesi Atatürk Eğitim ve Araştırma Hastanesi Kardiyoloji Kliniğinde 2016'dan 2017'ye kadar ki leadlerin dislokasyonu için lead revizyonuna ihtiyaç duyan hastalar geriye dönük olarak toplandı. Leadlerin dislokasyonu, çoğunlukla pil kontrolünde, daha düşük sens voltajı ya da yüksek pacing eşiği ile saptanır. KPM'deki bir ventriküler leadin dislokasyon insidansı % 0.5 ila % 2.5 olarak bilinir. Merkezimizde bu oranlardan daha düşük (<%0.03) olarak saptanmıştır. Jeneratör boyutu için uygun boyutta cep açmak, leadi uygun bir şekilde sabitlemek, jeneratörü sağlam bir dikişle pili cebe asmak, hasta eğitimi  leadin dislokasyonunu önlemek için önemlidir.

Anahtar Kelimeler

• Lead Dislokasyonları,İmplante Edilebilir Kardiyoverter Defibrilator,Kardiyak Pacemaker,Kardiyak Pacemaker İmplantasyon Komplikasyonları,Lead Dislokasyonları

Kaynakça

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