Facilitation of transvenous lead extraction using site-specific delivery of electrosurgical energy

John N. Catanzaro, Menekham Zviman, Aravindan Kolandaivelu, Saman Nazarian, Henry R Halperin, Ronald D Berger, Jeffrey A Brinker, Alan Cheng

Research output: Contribution to journalArticle

Abstract

Introduction: Excimer laser energy is often required to extract chronically indwelling pacemaker and defibrillator leads from the vasculature and myocardium. This technique can be associated with vascular and right ventricular (RV) injuries. We sought to develop a safer, more effective method by applying site-specific delivery of electrosurgical energy (EE). Methods: Utilizing a polyacrylamide gel model to simulate soft tissue density, active and passive fixation defibrillator and pacemaker leads were implanted and manually extracted with and without EE delivered to the cathode. The amount of force required for complete removal was measured using a force transducer. The procedure was then repeated in an acute pig model to demonstrate proof of safety. Post mortem gross and histologic specimens were collected from the implantation site. Results: In the gel model, the force required for extraction, using manual traction in the active (83.7. g) and passive (74.6. g) fixation ICD leads, was reduced by 37.8% and 33.5%, respectively with EE (both p.

Original languageEnglish (US)
Pages (from-to)75-77
Number of pages3
JournalIJC Heart and Vessels
Volume3
DOIs
StatePublished - 2014

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Keywords

  • Electrosurgical
  • Energy
  • Extraction
  • Implantable cardioverter-defibrillator
  • Lead
  • Pacemaker

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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