激光导管拔除心脏起搏除颤导线的临床应用研究

Objective The aim of this study is to investigate the safety and effectiveness of Excimer laser-assisted lead extraction. Methods Consecutive lead extraction in 16 patients using the excimer laser sheath from Veterans Administration Medical Center, University of Minnesota between March 2008 and December 2009 were analyzed retrospectively. The clinical characteristics including basic disease, cardiac function, indication and reason for lead removal, lead characteristic, and complication were summarized. Results Thirty one leads ( laser sheaths were used in 25 leads) in 16 patients mean age (67.4 ±9. 1 )years, range 54-82 years] were extracted. All leads were extracted successfully without complication.Most patients had severe heart diseases with left ventricular ejection fraction of 20% -60% (mean 36. 4% ±13.4% ). Mean implant time was (73.9 ±62. 9)months (range 3 -251 months). Nine patients had Class Ⅰ indications for lead extraction, 7 patients for Class Ⅱ indications. Atrial lead fractured in one patient during lead extraction, the remaining part of the lead was taken out from femoral vein by a snare-catheter apparatus. Another patient developed CS dissection and small pericardium perfusion during LV lead implantation (upgrade to BiV-ICD ) post successful lead extraction and patient discharged without complication. Conclusion Our single center experience suggests that Excimer Laser Sheath Lead Removal System is safe and effective in extracting pacemaker and ICD leads.

Pacemaker/ICD lead extraction with the excimer laser sheath: a single center experience