Document Detail

An ergonomic guide catheter slitting technique designed to avoid lead dislodgement.
MedLine Citation:
PMID:  18535891     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Guide catheters help deliver endocardial leads to specific locations within the heart, but their disengagement afterwards can be challenging. Slitting the catheter open over the lead may require the creation of an artificial platform to provide support for the blade and cause lead dislodgement through a sideways drag on the catheter by the hand pulling it or a forward push by the hand holding the blade. An alternative ergonomic technique addressing these shortcomings was developed. METHODS: The ipsilateral elbow presses against the iliac fossa or anterior superior iliac spine to support the hand holding the blade. The other hand pulls the catheter in small steps with constant adjustments of the direction of pull and the angle of the blade to ensure alignment of the different parts. If necessary, the hand pulling the catheter will drop it to reduce any loop in the catheter segment between the blade and the exit site of the catheter from the patient's body. The technique was tried on all guide catheters which required slitting during cardiac rhythm device procedures by a single operator. RESULTS: Thirty-two guide catheters from different manufacturers were successfully slit without dislodging any leads. The leads might slide forward into the heart during catheter slitting but their positions could all be adjusted by pulling them back afterwards. DISCUSSIONS: The ergonomic slitting technique should facilitate the use of guide catheters for positioning endocardial leads by reducing the risk of lead dislodgement. It proved useful and successful when applied to guide catheters from different manufacturers. Its general utility needs to be assessed in a wider clinical setting.
Ernest W Lau
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2008-06-06
Journal Detail:
Title:  Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing     Volume:  22     ISSN:  1383-875X     ISO Abbreviation:  J Interv Card Electrophysiol     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-07-24     Completed Date:  2008-12-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708966     Medline TA:  J Interv Card Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  227-31     Citation Subset:  IM    
Department of Cardiology, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, UK.
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MeSH Terms
Electrodes, Implanted*
Equipment Design*
Equipment Failure
Equipment Failure Analysis
Heart Catheterization / instrumentation*
Human Engineering / instrumentation*,  methods
Pacemaker, Artificial*
Prosthesis Implantation / instrumentation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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