This article is more than 5 years old. Information may no longer be current.
Laser lead extraction removed cardiac leads safely, effectively
Click Here to Manage Email Alerts
A new retrospective study examined the indications, complications and outcomes of 498 transvenous lead extraction procedures at a high-volume extraction center.
After a seven-year analysis, the researchers from Brigham and Women’s Hospital and Harvard Medical School concluded that the excimer laser sheath (Spectranetics Corporation) was safe and successful in removing pacing and defibrillator leads. Laser sheath technology uses ultraviolet light to ablate scar tissue that holds problematic leads in place.
In the analysis, 975 endovascular leads were removed from nearly 500 patients from January 2000 to March 2007. More than 97% of leads were successfully and completely removed.
The mean length of implantation was 5.7 years. Extraction using laser assistance was more likely with leads implanted longer than 3.4 years compared with those implanted less than 3.4 years (OR=6.15), the researchers wrote. In addition, extraction was more likely with implantable cardioverter-defibrillator leads compared with pacemaker leads (OR=3.44).
A small number of major complications were reported — two — which resulted in a major complication rate of just 0.4%. Only one patient required cardiac surgery, and no deaths were reported. – by Katie Kalvaitis
HeartRhythm. 2008;4:520-525.
Lead extraction is an important part of device implantation. Technological advances have helped accomplish extraction by freeing up leads that are scarred in place. This single-center experience demonstrates, as with most procedures, that high volume operators have better success and fewer complications. Physicians who extract leads infrequently should consider sending their patients to centers where the procedure is performed often.
– Douglas P. Zipes, MD
Cardiology Today Section Editor