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Related Experiment Video

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Lead extraction experience with high frequency excimer laser.

Tanyanan Tanawuttiwat1, Daniel Gallego, Roger G Carrillo

  • 1Cardiovascular Division, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida.

Pacing and Clinical Electrophysiology : PACE
|April 29, 2014
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Summary
This summary is machine-generated.

The high-frequency Excimer laser sheath offers a more efficient method for lead extraction, requiring less laser time and fewer pulses compared to lower-frequency options. This advanced approach demonstrates comparable success rates with low complication risks.

Keywords:
cardiac implantable electronic devicescomplicationsdevice infectionlaser Excimer sheathtransvenous lead extraction

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Area of Science:

  • Cardiovascular Interventions
  • Medical Device Technology
  • Electrophysiology

Background:

  • The Food and Drug Administration approved an 80-Hz pulse rate Excimer laser sheath in 2012.
  • This study reports initial clinical experiences with this high-frequency laser sheath, comparing it to previously used lower-frequency models.

Purpose of the Study:

  • To evaluate the clinical effectiveness and safety of a high-frequency Excimer laser sheath for lead extraction.
  • To compare procedural outcomes (laser time, pulse count, complications) between high-frequency and lower-frequency laser sheaths.

Main Methods:

  • A retrospective cohort study included 427 patients undergoing lead extraction between December 2008 and May 2013.
  • Patients using laser sheaths (excluding subclavian approaches) were analyzed, with primary endpoints being total laser time, pulse count, and complications.
  • Data on patient characteristics, lead details, and outcomes were prospectively collected.

Main Results:

  • Complete lead extraction was achieved in all 427 patients (72.6% male; age 67.9 ± 15.23 years).
  • The high-frequency laser sheath (n=112) was associated with significantly lower laser time and fewer laser pulses compared to the lower-frequency sheath (n=315), even after adjustments.
  • Mortality was 0.9% and minor complications were 3.6% in the high-frequency group.

Conclusions:

  • The high-frequency Excimer laser sheath is more efficient for lead extraction, requiring less laser time and fewer pulses than lower-frequency sheaths.
  • Success rates are comparable between the two laser sheath types.
  • Major and minor complication rates were low and not statistically different between the groups.