Several methodologies are typically employed to extract chronically-implanted pacing leads including: laser catheter systems, radio frequency catheters, mechanical cutting catheters, and/or direct traction. In the present study, Visible Heart® methodologies were employed to obtain novel internal and external views of such extractions. Utilizing standard cardioplegia procedures, canine hearts (n∈=∈3) with chronically-implanted endocardial pacing leads were explanted to a unique isolated heart apparatus. Modified Krebs-Henseleit buffer allowed for clear endocardial imaging with endoscopic video cameras inserted into the cardiac chambers. Leads were extracted using: (1) laser system with sheath; (2) dissection sheath with incorporated bipolar tungsten electrode; (3) non-powered mechanical sheath; or (4) direct traction. Resultant images provide a novel perspective regarding lead extraction methodologies and the imposed force on an encapsulated lead and on the great vessels and/or heart itself; this understanding may improve the outcome and safety of future lead extractions.
|Original language||English (US)|
|Number of pages||5|
|Journal||Journal of Interventional Cardiac Electrophysiology|
|State||Published - Jan 2009|
Bibliographical noteFunding Information:
Acknowledgements The authors would like to thank the Visible Heart® staff for assistance with this study, Dr. Nicholas Skadsberg for his comments, and Monica Mahre for her help in preparation of this manuscript. We would also like to thank Cook Vascular and Spectranetics for their support of this project and for providing the extraction tools used to remove the leads. This work was funded in part by Medtronic, Inc. and the Institute for Engineering in Medicine at the University of Minnesota.
Copyright 2009 Elsevier B.V., All rights reserved.
- Laser system
- Lead extraction
- RF cutting