Superior Vena Cava Defibrillator Coils Make Transvenous Lead Extraction More Challenging and Riskier
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According to guidelines, decisions about the need for a pacemaker are influenced by the presence or absence of symptoms directly attributable to bradycardia.
“According to the guidelines, “decisions about the need for a pacemaker are necessarily influenced by the presence or absence of symptoms directly attributable to bradycardia” [4].”
From General anesthesia with a transcutaneous pacemaker for a Noonan syndrome patient with advanced atrioventricular block discovered in the remote period after open-heart surgery: a case report (2023) · cites this paper as [4]
The paper’s methods and results passages concern transvenous extraction of defibrillator leads, not decisions to implant a pacemaker. Searches for the quoted wording and for pacemaker indications, bradycardia, symptoms, and guidelines found no passage addressing the claimed guidance; the Heart Rhythm Society consensus mentioned in the methods concerns lead management. (LLM, conf=0.76)
Experimental — accuracy not yet measuredAsymptomatic third-degree atrioventricular block with an average ventricular rate of 40 bpm or faster when awake is considered class II for permanent pacing, whereas bradycardia with symptoms presumed due to atrioventricular block is class I.
“With regard to the recommendations for permanent pacing, asymptomatic third-degree AVB with an average ventricular rate of 40 bpm or faster when awake would be considered class II (there is conflicting evidence and/or a divergence of opinion), whereas bradycardia with symptoms presumed to be due to AVB would be class I (there is evidence and/or general agreement).”
From General anesthesia with a transcutaneous pacemaker for a Noonan syndrome patient with advanced atrioventricular block discovered in the remote period after open-heart surgery: a case report (2023) · cites this paper as [4]
Split into 2 atoms — 0 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 2 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredFormalized cutoffs for sinus node dysfunction are arbitrary, although a sinus rate <40 bpm is considered potentially causative in a symptomatic patient.
“It is strongly recommended to establish symptom/ rhythm correlation, as formalized cutoffs are arbitrary although a sinus rate ,40 bpm is considered potentially causative in a symptomatic patient (Epstein et al., 2013).”
From 2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry (2017) · cites this paper as Epstein et al., 2013
The paper’s study description and results address the difficulty and complications of extracting defibrillator leads with superior vena cava coils; no page numbers are supplied in our copy. Searches for sinus node dysfunction, symptom–rhythm correlation, and a sinus rate below 40 bpm found no passage addressing the cited claim. (LLM, conf=0.78)
Experimental — accuracy not yet measuredIndications for pacemaker implantations in patients with congenital complete heart block are largely predicated on the presence of prolonged pauses, low average heart rates, or complex ventricular ectopy on Holter monitoring.
“Indications for pacemaker implantations in patients with congenital complete heart block are largely predicated on the presence of prolonged pauses, low average heart rates, or complex ventricular ectopy on Holter monitoring”
From 2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry (2017) · cites this paper as Epstein et al., 2013
The paper’s introduction and results discuss extraction of implantable cardioverter-defibrillator leads, particularly the risks associated with superior vena cava coils. Searches for congenital complete heart block, Holter monitoring, and pacemaker implantation indications found no passage addressing the claimed criteria. (LLM, conf=0.78)
Experimental — accuracy not yet measuredFollowing MUSTT, there is a role for AECG for NSVT detection in post-MI patients with LVEF 35%-40% as electrophysiologically guided ICD implantation improves survival.
“Following the Multicenter Unsustained Tachycardia Trial (MUSTT) (Buxton et al., 1999), there is a role for AECG for NSVT detection in post-MI patients with LVEF 35%-40% as electrophysiologically guided ICD implantation improves survival”
From 2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry (2017) · cites this paper as Epstein et al., 2013
The paper’s opening and conclusion address the difficulty and complications of extracting ICD leads with superior vena cava coils; page numbers are unavailable in our copy. Searches for MUSTT, NSVT detection, post-MI ejection fraction, and electrophysiologically guided ICD implantation found no passage addressing the claim. (LLM, conf=0.78)
Experimental — accuracy not yet measured
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- Authors
- Epstein, L. M., Love, C. J., Wilkoff, B. L., Chung, M. K., Hackler, J. W., Bongiorni, M. G., Segreti, L., Carrillo, R. G., Baltodano, P., Fischer, A., Kennergren, C., Viklund, R., Mittal, S., Arshad, A., Ellenbogen, K. A., John, R. M., & Maytin, M.
- Affiliations
- Brigham and Women's Hospital (US)
- The Ohio State University Wexner Medical Center (US)
- Cleveland Clinic Lerner College of Medicine (US)
- University of Pisa (IT)
- University of Miami (US)
- Icahn School of Medicine at Mount Sinai (US)
- Sahlgrenska University Hospital (SE)
- Columbia University (US)
- Virginia Commonwealth University (US)
- Corresponding author
- Maytin, Melanie
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2013-03
- Volume
- 61
- Issue
- 9
- Pages
- 987-989
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W1982690035
- Cited by
- 467
- References
- 8
- Citations by year
- 2026: 6 · 2025: 12 · 2024: 8 · 2023: 13 · 2022: 19 · 2021: 26 · 2020: 30 · 2019: 40 · 2018: 58 · 2017: 84 · 2016: 52 · 2015: 51 · 2014: 44 · 2013: 24
- FWCI
- 35.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
- Funders
- Boston Scientific
- Medtronic
- Spectranetics
- St. Jude Medical
- Biotronik
- LifeWatch
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Keywords
- implantable cardioverter-defibrillator leads, dual-coil leads, transvenous lead extraction, superior vena cava, lead extraction complications, defibrillation efficacy, all-cause mortality
- MeSH terms
- Female, Humans, Male, Middle Aged, Retrospective Studies, Vena Cava, Superior, Treatment Outcome, Defibrillators, Implantable
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