[Initial experience in Russia of excimer laser extraction of endocardial leads]

To assess effectiveness and safety of excimer laser extraction of chronically implanted transvenous pacing leads using countertraction technique. We operated upon 10 patients (female 2), mean age 56.1+/-11.7 years. Average time of lead placement was 7.7+/-4.2 years. Indications included erosion of device pocket in 4 patients, abscess of pocket in 2 patients, high grade of tricuspid valve insufficiency in 1 patient with 2 ventricular leads, lead related induction of life-threatening ventricular tachycardia in 3 ICD patients. We used xenon-chloride laser with excimer laser sheath SLS n KIT 14-16 Fr and locking stylet LLD KIT (Spectranetics, USA). Endotracheal anesthesia was applied in all cases. Leads removal was a success for 3 atrial and 12 ventricular leads. All endocardial leads were extracted with countertraction after near-the-complete progression of the laser sheath. Postoperative follow-up period was 16.3+/-5.7 months. There were no procedure-related complications.

Laser lead extraction is a safe and effective approach to removal of long-term leads including those with active fixation.