Mission impossible - Akademia elektroterapii

„Mission impossible” or ???
Everybody must not do everything – terrible patient can
be send to another TLE centre – why not ?
Andrzej Kutarski
Dept of Cardiology Medical University of
Poland
Lublin,
„Mission impossible” or ???
History:
2003 implantation VVI-ICD system (Lt side)
2006 lead P/S circuit damage with non-adequate HVT
2006 The new VVI ICD system implanted (Right side)
Sinus bradycardia, >90% VVIp with retrograde VA
conduction, frequent AF episodes
„Mission impossible” or ???
55-y old patient with
HCM, sinus bradyc.
and retrograde
conduction.
VVI pacing up to his
end of life ?
„Mission impossible” or ???
Abandoned old, damaged - ICD lead extraction
„Mission impossible” or ???
Abandoned old, damaged - ICD lead was
extracted
The new RAA lead was implanted
The unit was replaced for DDD
„Mission impossible” or ???
Conclusions:
1. Better not to abandon ICD lead in young patient
2. Better to utilise one site of the chest for the system in
young patient
3. System should be proper for the patient
4. System upgrading should be completed with
abandoned lead extraction
5. Better to avoid simple lead traction if there is no
possibility to perform it successfull extraction
Thanks for your attention
a_kutarski@yahoo.com