Extraction of chronic pacemaker and defibrillator leads from the coronary sinus: laser infrequently used but required

Shoaib Hamid; Aruna Arujuna; Aruna Arujna; Sitara Khan; Andrew Ladwiniec; Mark McPhail; Julian Bostock; Margaret Mobb; Nik Patel; Cliff Bucknall; Christopher A Rinaldi

doi:10.1093/europace/eun374

Extraction of chronic pacemaker and defibrillator leads from the coronary sinus: laser infrequently used but required

Shoaib Hamid, Aruna Arujuna, Aruna Arujna, Sitara Khan, Andrew Ladwiniec, Mark McPhail, Julian Bostock, Margaret Mobb, Nik Patel, Cliff Bucknall, Christopher A Rinaldi

Imaging and Biomedical Engineering

St Thomas' Hospital

Research output: Contribution to journal › Article › peer-review

42 Citations (Scopus)

Abstract

AIMS: Cardiac resynchronization therapy is an accepted treatment for heart failure but it may be necessary to explant these systems along with their leads. The evidence base for coronary sinus (CS) lead extractions is limited. We aimed to evaluate the percutaneous removal of these leads and the utility of laser extraction when necessary.

METHODS AND RESULTS: Of 265 patients referred for lead extraction between January 2004 and June 2008, 32 (12.1%) involved CS leads (30 males, mean age 67 years). Mean implantation time was 26.5 +/- 28.7 months (range 1-116 months). Indications for extraction were pocket infection (34.4%), lead malfunction (43.8%), skin erosion (15.6%), and endocarditis (6.2%). Twenty-eight (87.5%) CS leads were removed with manual traction, with laser utilized in four cases (12.5%). No major complications of CS laceration, pericardial effusion, emergency surgery, or death occurred.

CONCLUSION: Our experience supports the percutaneous extraction of CS leads as a safe and effective procedure including the utility of laser when necessary.

Original language	English
Pages (from-to)	213-5
Number of pages	3
Journal	Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
Volume	11
Issue number	2
DOIs	https://doi.org/10.1093/europace/eun374
Publication status	Published - Feb 2009

Keywords

Adult
Aged
Aged, 80 and over
Cardiovascular Surgical Procedures/adverse effects
Coronary Sinus/surgery
Defibrillators, Implantable
Device Removal/adverse effects
Female
Heart Diseases/therapy
Humans
Laser Therapy/adverse effects
Male
Middle Aged
Pacemaker, Artificial
Prospective Studies
Retrospective Studies
Treatment Outcome

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10.1093/europace/eun374

Cite this

Hamid, S., Arujuna, A., Arujna, A., Khan, S., Ladwiniec, A., McPhail, M., Bostock, J., Mobb, M., Patel, N., Bucknall, C., & Rinaldi, C. A. (2009). Extraction of chronic pacemaker and defibrillator leads from the coronary sinus: laser infrequently used but required. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 11(2), 213-5. https://doi.org/10.1093/europace/eun374

Hamid, Shoaib ; Arujuna, Aruna ; Arujna, Aruna et al. / Extraction of chronic pacemaker and defibrillator leads from the coronary sinus : laser infrequently used but required. In: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2009 ; Vol. 11, No. 2. pp. 213-5.

@article{de34626467434345800b7030eab1c8de,

title = "Extraction of chronic pacemaker and defibrillator leads from the coronary sinus: laser infrequently used but required",

abstract = "AIMS: Cardiac resynchronization therapy is an accepted treatment for heart failure but it may be necessary to explant these systems along with their leads. The evidence base for coronary sinus (CS) lead extractions is limited. We aimed to evaluate the percutaneous removal of these leads and the utility of laser extraction when necessary.METHODS AND RESULTS: Of 265 patients referred for lead extraction between January 2004 and June 2008, 32 (12.1%) involved CS leads (30 males, mean age 67 years). Mean implantation time was 26.5 +/- 28.7 months (range 1-116 months). Indications for extraction were pocket infection (34.4%), lead malfunction (43.8%), skin erosion (15.6%), and endocarditis (6.2%). Twenty-eight (87.5%) CS leads were removed with manual traction, with laser utilized in four cases (12.5%). No major complications of CS laceration, pericardial effusion, emergency surgery, or death occurred.CONCLUSION: Our experience supports the percutaneous extraction of CS leads as a safe and effective procedure including the utility of laser when necessary.",

keywords = "Adult, Aged, Aged, 80 and over, Cardiovascular Surgical Procedures/adverse effects, Coronary Sinus/surgery, Defibrillators, Implantable, Device Removal/adverse effects, Female, Heart Diseases/therapy, Humans, Laser Therapy/adverse effects, Male, Middle Aged, Pacemaker, Artificial, Prospective Studies, Retrospective Studies, Treatment Outcome",

author = "Shoaib Hamid and Aruna Arujuna and Aruna Arujna and Sitara Khan and Andrew Ladwiniec and Mark McPhail and Julian Bostock and Margaret Mobb and Nik Patel and Cliff Bucknall and Rinaldi, {Christopher A}",

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doi = "10.1093/europace/eun374",

language = "English",

volume = "11",

pages = "213--5",

journal = "Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology",

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Hamid, S, Arujuna, A, Arujna, A, Khan, S, Ladwiniec, A, McPhail, M, Bostock, J, Mobb, M, Patel, N, Bucknall, C & Rinaldi, CA 2009, 'Extraction of chronic pacemaker and defibrillator leads from the coronary sinus: laser infrequently used but required', Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, vol. 11, no. 2, pp. 213-5. https://doi.org/10.1093/europace/eun374

Extraction of chronic pacemaker and defibrillator leads from the coronary sinus: laser infrequently used but required. / Hamid, Shoaib; Arujuna, Aruna; Arujna, Aruna et al.
In: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, Vol. 11, No. 2, 02.2009, p. 213-5.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Extraction of chronic pacemaker and defibrillator leads from the coronary sinus

T2 - laser infrequently used but required

AU - Hamid, Shoaib

AU - Arujuna, Aruna

AU - Arujna, Aruna

AU - Khan, Sitara

AU - Ladwiniec, Andrew

AU - McPhail, Mark

AU - Bostock, Julian

AU - Mobb, Margaret

AU - Patel, Nik

AU - Bucknall, Cliff

AU - Rinaldi, Christopher A

PY - 2009/2

Y1 - 2009/2

N2 - AIMS: Cardiac resynchronization therapy is an accepted treatment for heart failure but it may be necessary to explant these systems along with their leads. The evidence base for coronary sinus (CS) lead extractions is limited. We aimed to evaluate the percutaneous removal of these leads and the utility of laser extraction when necessary.METHODS AND RESULTS: Of 265 patients referred for lead extraction between January 2004 and June 2008, 32 (12.1%) involved CS leads (30 males, mean age 67 years). Mean implantation time was 26.5 +/- 28.7 months (range 1-116 months). Indications for extraction were pocket infection (34.4%), lead malfunction (43.8%), skin erosion (15.6%), and endocarditis (6.2%). Twenty-eight (87.5%) CS leads were removed with manual traction, with laser utilized in four cases (12.5%). No major complications of CS laceration, pericardial effusion, emergency surgery, or death occurred.CONCLUSION: Our experience supports the percutaneous extraction of CS leads as a safe and effective procedure including the utility of laser when necessary.

AB - AIMS: Cardiac resynchronization therapy is an accepted treatment for heart failure but it may be necessary to explant these systems along with their leads. The evidence base for coronary sinus (CS) lead extractions is limited. We aimed to evaluate the percutaneous removal of these leads and the utility of laser extraction when necessary.METHODS AND RESULTS: Of 265 patients referred for lead extraction between January 2004 and June 2008, 32 (12.1%) involved CS leads (30 males, mean age 67 years). Mean implantation time was 26.5 +/- 28.7 months (range 1-116 months). Indications for extraction were pocket infection (34.4%), lead malfunction (43.8%), skin erosion (15.6%), and endocarditis (6.2%). Twenty-eight (87.5%) CS leads were removed with manual traction, with laser utilized in four cases (12.5%). No major complications of CS laceration, pericardial effusion, emergency surgery, or death occurred.CONCLUSION: Our experience supports the percutaneous extraction of CS leads as a safe and effective procedure including the utility of laser when necessary.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Cardiovascular Surgical Procedures/adverse effects

KW - Coronary Sinus/surgery

KW - Defibrillators, Implantable

KW - Device Removal/adverse effects

KW - Female

KW - Heart Diseases/therapy

KW - Humans

KW - Laser Therapy/adverse effects

KW - Male

KW - Middle Aged

KW - Pacemaker, Artificial

KW - Prospective Studies

KW - Retrospective Studies

KW - Treatment Outcome

U2 - 10.1093/europace/eun374

DO - 10.1093/europace/eun374

M3 - Article

C2 - 19168497

SN - 1099-5129

VL - 11

SP - 213

EP - 215

JO - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

JF - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

IS - 2

ER -

Hamid S, Arujuna A, Arujna A, Khan S, Ladwiniec A, McPhail M et al. Extraction of chronic pacemaker and defibrillator leads from the coronary sinus: laser infrequently used but required. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2009 Feb;11(2):213-5. doi: 10.1093/europace/eun374

Extraction of chronic pacemaker and defibrillator leads from the coronary sinus: laser infrequently used but required

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