OBJECTIVES: Laser lead extraction is a challenging procedure, especially in patients with old or multiple pacemaker (PM) or implantable cardioverter defibrillator (ICD) leads. The mechanical force is a leading cause of complications during the extraction procedure. Use of new laser sheaths, which deliver a rate of 80 pulses per second, may probably reduce intraoperative adverse events by reduction of extraction force. METHODS: Between January 2012 and April 2013, 76 PM and ICD leads were treated in 38 patients using GlideLight 80 Hz laser sheaths. Indications for lead removals were pocket infection (42.1%), septicaemia or endocarditis (23.7%), lead dysfunction (31.6%) and upgrade from PM to ICD (2.6%). Data on procedural success rates, intra- and postoperative outcomes, as well as 30-day mortality were collected into a database and analysed retrospectively. RESULTS: The mean patient age was 62.0 ± 17.7 years (range 18-83), and 73.7% were male. The mean time from initial lead implantation was 96.0 ± 58.3 months (range 24-288). Thirty-seven (48.7%) PM and 39 (51.3%) ICD leads had to be extracted. The mean procedural time was 68.3 ± 27.3 min (range 35-115). Seventy-two of 76 leads (94.8%) were completely removed, partial removal was achieved in 2 (2.6%) leads and a failure of extraction occurred in 2 (2.6%) leads. The overall complication rate was 5.2%, including one major (superior vena cava perforation) (2.6%) and one minor (pocket haematoma) (2.6%) complication. No death occurred during the 30-day follow-up. CONCLUSIONS: The GlideLight 80 Hz laser sheath allows safe and effective removal of chronically implanted PM and ICD leads, combining high procedural success with low complication rates.
OBJECTIVES: Laser lead extraction is a challenging procedure, especially in patients with old or multiple pacemaker (PM) or implantable cardioverter defibrillator (ICD) leads. The mechanical force is a leading cause of complications during the extraction procedure. Use of new laser sheaths, which deliver a rate of 80 pulses per second, may probably reduce intraoperative adverse events by reduction of extraction force. METHODS: Between January 2012 and April 2013, 76 PM and ICD leads were treated in 38 patients using GlideLight 80 Hz laser sheaths. Indications for lead removals were pocket infection (42.1%), septicaemia or endocarditis (23.7%), lead dysfunction (31.6%) and upgrade from PM to ICD (2.6%). Data on procedural success rates, intra- and postoperative outcomes, as well as 30-day mortality were collected into a database and analysed retrospectively. RESULTS: The mean patient age was 62.0 ± 17.7 years (range 18-83), and 73.7% were male. The mean time from initial lead implantation was 96.0 ± 58.3 months (range 24-288). Thirty-seven (48.7%) PM and 39 (51.3%) ICD leads had to be extracted. The mean procedural time was 68.3 ± 27.3 min (range 35-115). Seventy-two of 76 leads (94.8%) were completely removed, partial removal was achieved in 2 (2.6%) leads and a failure of extraction occurred in 2 (2.6%) leads. The overall complication rate was 5.2%, including one major (superior vena cava perforation) (2.6%) and one minor (pocket haematoma) (2.6%) complication. No death occurred during the 30-day follow-up. CONCLUSIONS: The GlideLight 80 Hz laser sheath allows safe and effective removal of chronically implanted PM and ICD leads, combining high procedural success with low complication rates.
Entities:
Keywords:
Implantable cardioverter defibrillators; Laser lead extraction; Pacemaker
Authors: C J Love; B L Wilkoff; C L Byrd; P H Belott; J A Brinker; N E Fearnot; R A Friedman; S Furman; L B Goode; D L Hayes; D T Kawanishi; V Parsonnet; C Reiser; H J Van Zandt Journal: Pacing Clin Electrophysiol Date: 2000-04 Impact factor: 1.976
Authors: Charles L Byrd; Bruce L Wilkoff; Charles J Love; T Duncan Sellers; Christopher Reiser Journal: Pacing Clin Electrophysiol Date: 2002-05 Impact factor: 1.976
Authors: B L Wilkoff; C L Byrd; C J Love; D L Hayes; T D Sellers; R Schaerf; V Parsonnet; L M Epstein; R A Sorrentino; C Reiser Journal: J Am Coll Cardiol Date: 1999-05 Impact factor: 24.094
Authors: Bruce L Wilkoff; Charles J Love; Charles L Byrd; Maria Grazia Bongiorni; Roger G Carrillo; George H Crossley; Laurence M Epstein; Richard A Friedman; Charles E H Kennergren; Przemyslaw Mitkowski; Raymond H M Schaerf; Oussama M Wazni Journal: Heart Rhythm Date: 2009-05-22 Impact factor: 6.343
Authors: Simon Pecha; Muhammed Ali Aydin; Yalin Yildirim; Björn Sill; Beate Reiter; Iris Wilke; Hermann Reichenspurner; Hendrik Treede Journal: Europace Date: 2013-02-20 Impact factor: 5.214
Authors: Gust H Bardy; Kerry L Lee; Daniel B Mark; Jeanne E Poole; Douglas L Packer; Robin Boineau; Michael Domanski; Charles Troutman; Jill Anderson; George Johnson; Steven E McNulty; Nancy Clapp-Channing; Linda D Davidson-Ray; Elizabeth S Fraulo; Daniel P Fishbein; Richard M Luceri; John H Ip Journal: N Engl J Med Date: 2005-01-20 Impact factor: 91.245
Authors: C Kennergren; C A Bucknall; C Butter; R Charles; J Fuhrer; M Grosfeld; R Tavernier; T B Morgado; P Mortensen; V Paul; P Richter; T Schwartz; F Wellens Journal: Europace Date: 2007-06-27 Impact factor: 5.214
Authors: Simon Pecha; Liesa Castro; Julia Vogler; Matthias Linder; Nils Gosau; Stephan Willems; Hermann Reichenspurner; Samer Hakmi Journal: Heart Vessels Date: 2018-04-05 Impact factor: 2.037