BACKGROUND: An increasing need for laser lead extraction has grown in parallel with the increase of implantation of pacing and defibrillating devices. We reviewed the initial experience of a regional laser-assisted lead extraction program serving Atlantic Canada. METHODS: We retrospectively reviewed the cases of all consecutive patients who underwent laser lead extraction at the Maritime Heart Centre in Halifax, NS, between 2006 and 2015. We conducted univariate and Kaplan-Meier survivorship analyses. RESULTS: During the 9-year study period, 108 consecutive patients underwent laser lead extractions (218 leads extracted). The most common indication for extraction was infection (84.3%). Most patients were older than 60 years (73.1%) and had leads chronically implanted; the explanted leads were an average of 7.5 ± 6.8 years old. Procedural and clinical success (resolution of preoperative symptoms) rates and mortality were 96.8%, 97.2%, and 0.9%, respectively. Sternotomy procedures were performed in 3 instances: once for vascular repair due to perforation and twice to ensure that all infected lead material was removed. No minor complications required surgical intervention. Survival after discharge was 98.4% at 30 days and 94% at 12 months. CONCLUSION: Atlantic Canada's sole surgical extraction centre achieved high extraction success with a low complication rate. Lead extraction in an operative setting provides for immediate surgical intervention and is essential for the survival of patients with complicated cases. Surgeons must weigh the risks versus benefits in patients older than 60 years who have chronically implanted leads (> 1 yr) and infection.
BACKGROUND: An increasing need for laser lead extraction has grown in parallel with the increase of implantation of pacing and defibrillating devices. We reviewed the initial experience of a regional laser-assisted lead extraction program serving Atlantic Canada. METHODS: We retrospectively reviewed the cases of all consecutive patients who underwent laser lead extraction at the Maritime Heart Centre in Halifax, NS, between 2006 and 2015. We conducted univariate and Kaplan-Meier survivorship analyses. RESULTS: During the 9-year study period, 108 consecutive patients underwent laser lead extractions (218 leads extracted). The most common indication for extraction was infection (84.3%). Most patients were older than 60 years (73.1%) and had leads chronically implanted; the explanted leads were an average of 7.5 ± 6.8 years old. Procedural and clinical success (resolution of preoperative symptoms) rates and mortality were 96.8%, 97.2%, and 0.9%, respectively. Sternotomy procedures were performed in 3 instances: once for vascular repair due to perforation and twice to ensure that all infected lead material was removed. No minor complications required surgical intervention. Survival after discharge was 98.4% at 30 days and 94% at 12 months. CONCLUSION: Atlantic Canada's sole surgical extraction centre achieved high extraction success with a low complication rate. Lead extraction in an operative setting provides for immediate surgical intervention and is essential for the survival of patients with complicated cases. Surgeons must weigh the risks versus benefits in patients older than 60 years who have chronically implanted leads (> 1 yr) and infection.
Authors: Jeff S Healey; Richard Merchant; Chris Simpson; Timothy Tang; Marianne Beardsall; Stanley Tung; Jennifer A Fraser; Laurene Long; Janet M van Vlymen; Pirjo Manninen; Fiona Ralley; Lashmi Venkatraghavan; Raymond Yee; Bruce Prasloski; Shubhayan Sanatani; François Philippon Journal: Can J Anaesth Date: 2012-04 Impact factor: 5.063
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: Arnold J Greenspon; Jasmine D Patel; Edmund Lau; Jorge A Ochoa; Daniel R Frisch; Reginald T Ho; Behzad B Pavri; Steven M Kurtz Journal: J Am Coll Cardiol Date: 2011-08-30 Impact factor: 24.094
Authors: Arnold J Greenspon; Jasmine D Patel; Edmund Lau; Jorge A Ochoa; Daniel R Frisch; Reginald T Ho; Behzad B Pavri; Steven M Kurtz Journal: J Am Coll Cardiol Date: 2012-09-19 Impact factor: 24.094
Authors: Anton Sabashnikov; Prashant N Mohite; Bartlomiej Zych; Diana García; Aron-Frederik Popov; Alexander Weymann; Nikhil P Patil; Rachel Hards; Massimo Capoccia; Thorsten Wahlers; Fabio De Robertis; Toufan Bahrami; Mohamed Amrani; Nicholas R Banner; André R Simon Journal: ASAIO J Date: 2014 Mar-Apr Impact factor: 2.872