Initial experience using Excimer laser for the extraction of chronically implanted pacemaker and implantable cardioverter defibrillator leads in Japanese patients

Hideo Okamura, Satoshi Yasuda, Shunsuke Sato, Koji Ogawa, Ikutaro Nakajima, Takashi Noda, Yusuke Shimahara, Teruyuki Hayashi, Yoshihiko Onishi, Junjiro Kobayashi, Shiro Kamakura, Hisao Ogawa, Wataru Shimizu

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Given the exponential growth in cardiac device implantations, the need for less invasive lead extraction is increasing. The Excimer laser was approved for lead removal in Japan in 2010. The present study reports the initial experience using this novel technique to extract chronically implanted pacemaker and implantable cardioverter defibrillator (ICD) leads from Japanese patients. Methods and results: We performed a retrospective study of consecutive patients undergoing lead extraction using the laser sheath at a single Japanese center. Patient and lead characteristics, indications, and outcomes were analyzed. From August 2010 to September 2012, a total of 70 leads, including 14 ICD leads, were removed using the laser sheath from 40 patients (26 male, 14 female; age 65.5±18.3 [mean±SD] years; body mass index 21.8±3.5kg/m2). The median implant duration was 87 months (range 13-328 months). Indications were infection (n=35), venous occlusion (n=4), and pain (n=1). The femoral approach was used in combination with the laser technique in five cases. Complete procedural success was achieved with 68 leads (97.1%). Although the electrode tip was left behind in the remaining two leads, the desired clinical outcomes could be achieved; which were defined as clinical success. No cases resulted in failure. There were no major complications, including death and bleeding requiring open-chest surgery. Conclusions: Laser sheaths appear to provide a feasible and effective means of extracting chronically implanted pacemaker and ICD leads in Japanese patients.

Original languageEnglish
Pages (from-to)195-200
Number of pages6
JournalJournal of cardiology
Volume62
Issue number3
DOIs
Publication statusPublished - 2013 Sep

Keywords

  • Defibrillator
  • Infectious disease
  • Laser
  • Lead extraction
  • Pacemaker

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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