Initial experience of pacemaker and implantable cardioverter defibrillator lead extraction with the new GlideLight 80 Hz laser sheaths
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Initial experience of pacemaker and implantable cardioverter defibrillator lead extraction with the new GlideLight 80 Hz laser sheaths. / Hakmi, Samer; Pecha, Simon; Sill, Björn; Reiter, Beate; Willems, Stephan; Aydin, Muhammet Ali; Yildirim, Yalin; Reichenspurner, Hermann; Treede, Hendrik.
in: INTERACT CARDIOV TH, Jahrgang 18, Nr. 1, 01.2014, S. 56-60.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Initial experience of pacemaker and implantable cardioverter defibrillator lead extraction with the new GlideLight 80 Hz laser sheaths
AU - Hakmi, Samer
AU - Pecha, Simon
AU - Sill, Björn
AU - Reiter, Beate
AU - Willems, Stephan
AU - Aydin, Muhammet Ali
AU - Yildirim, Yalin
AU - Reichenspurner, Hermann
AU - Treede, Hendrik
PY - 2014/1
Y1 - 2014/1
N2 - 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.
AB - 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.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Catheters
KW - Defibrillators, Implantable
KW - Device Removal/adverse effects
KW - Humans
KW - Laser Therapy/adverse effects
KW - Lasers, Excimer
KW - Male
KW - Middle Aged
KW - Pacemaker, Artificial
KW - Postoperative Complications/etiology
KW - Prosthesis Design
KW - Retrospective Studies
KW - Risk Factors
KW - Time Factors
KW - Treatment Outcome
KW - Young Adult
U2 - 10.1093/icvts/ivt428
DO - 10.1093/icvts/ivt428
M3 - SCORING: Journal article
C2 - 24087832
VL - 18
SP - 56
EP - 60
JO - INTERACT CARDIOV TH
JF - INTERACT CARDIOV TH
SN - 1569-9293
IS - 1
ER -