Features November 2016 Issue

Study: Removing Nonfunctioning ICD Leads Safer in the Long Run

The arrow in Figure A shows an abandoned ICD lead that had fractured. In Fiture B, the lead has been repaired and put to work. This is sometimes an option, but often nonfunctioning leads are abandoned or removed.

Study: Removing Nonfunctioning ICD Leads Safer in the Long Run

Cleveland Clinic researchers find that extracting ICD leads that are no longer working may reduce complications if the ICD must be replaced later.

One of the unfortunate aspects of having an implantable cardiorverter defibrillator (ICD) is that the wiry leads that extend from the main unit into the heart can sometimes stop working. The ICD itself can also malfunction or become infected, which means it must be removed. A recent Cleveland Clinic study found that if nonfunctioning leads are left in place, later removal of an infected ICD is associated with worse outcomes and more complications for the patient. Conversely, patients in the study who had their nonfunctioning leads extracted prior to needing a replacement ICD have much better outcomes.

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