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Total laser cycles—a measure of transvenous lead extraction difficulty

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

Several variables have been identified as predictors for difficult or complicated transvenous lead extraction (TLE), including age and number of implanted leads, as well as patient’s age; however, a standard measure of TLE difficulty has not been described.

Objective

Total laser cycles (TLCs) delivered during laser-assisted TLE is an objective variable that could reflect the difficulty of TLE. This study investigated whether TLC is correlated with known predictors of difficult TLE.

Methods

In a retrospective study of TLE procedures using the laser sheath, we analyzed TLC delivered and compared it to established predictors of procedural failure and complications.

Results

Of 166 patients undergoing TLE, the laser sheath (SLS II or Glidelight, Spectranetics Inc.,) was used as the primary extraction sheath in 130 patients, and 100 patients had complete TLC data available. The mean age of the oldest lead (AOL) was 7.1 ± 3.2 years with a median of 6.91 (interquartile range [IQR] 0.48–16.69) years, and 1.6 ± 0.7 leads (range, 1–4) were extracted per procedure. Two thirds of procedures involved ICD leads. Clinical success was 99%, with one patient (1%) experiencing a major complication. Median TLC delivered was 1165 (IQR, 567–2062; range, 49–9522). TLC was positively correlated with AOL (r = 0.227, p = 0.023), and the combined age of leads was extracted (r = 0.307, p = 0.002). TLC was also positively correlated with number of leads extracted per procedure (ρ = 0.227, p = 0.024). There was a non-significant negative trend towards correlation between TLC and patient’s age (r = −0.112, p = 0.268).

Conclusion

TLC showed significant correlation with known predictors of difficulty during TLE using the laser sheath. TLC is an objective method to report the difficulty of TLE and could usefully be reported in future series of laser lead extractions.

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Authors and Affiliations

  1. Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, Hartford, CT, USA

    Ossama Elsaid, Steven Zweibel & Edmond M. Cronin

  2. Research Administration, Hartford HealthCare, Hartford, CT, USA

    David M. O’Sullivan

  3. University of Connecticut School of Medicine, Farmington, CT, USA

    Steven Zweibel & Edmond M. Cronin

Authors
  1. Ossama Elsaid
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  2. David M. O’Sullivan
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  3. Steven Zweibel
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  4. Edmond M. Cronin
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Correspondence to Ossama Elsaid.

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Elsaid, O., O’Sullivan, D.M., Zweibel, S. et al. Total laser cycles—a measure of transvenous lead extraction difficulty. J Interv Card Electrophysiol 53, 383–389 (2018). https://doi.org/10.1007/s10840-018-0422-3

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  • DOI: https://doi.org/10.1007/s10840-018-0422-3

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