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2018 ; 14
(1
): 15-25
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Complications of electrotherapy - the dark side of treatment with cardiac
implantable electronic devices
#MMPMID29743900
Domaga?a S
; Domaga?a M
; Chy?a J
; Wojciechowska C
; Janion M
; Polewczyk A
Postepy Kardiol Interwencyjnej
2018[]; 14
(1
): 15-25
PMID29743900
show ga
In the past years we have been observing the dynamic development of
electrotherapy, as evidenced by the steadily rising number of implanted
pacemakers (PM), as well as devices used in the treatment of dangerous arrhythmia
and heart failure, such as implantable cardioverter defibrillators (ICD) and
cardiac resynchronisation therapy (CRT-P/D). This is a consequence of the ageing
of the populations of the majority of developed countries and also the gradually
widening indications for the use of such devices. Along with the observed rise in
the number of new implantations, the number of complications of electrotherapy is
rising as well. In view of the increase in the incidence of complications, it is
necessary to systematize the knowledge on this subject, because there is still no
official classification of this type of complication and guidelines for dealing
with such cases do not appear to cover the scale of the problem. In addition,
late complications of electrotherapy play the most important role, in which case
the removal of the entire pacing system, transvenous lead extraction (TLE), is a
challenge due to the older age of leads strongly attached to the venous walls and
endocardium of the heart cavity. The present paper presents a modern
classification of electrotherapy complications and discusses the types of
complications according to the most recent literature reports. Moreover, the
diagnosis and management of particular types of complications with the assessment
of indications for TLE are discussed.