Safety and Efficacy of Transvenous Lead Extraction With a High-Frequency Excimer Laser　― A Single Center Experience ―

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  • Yoshitake Takakatsu
    Department of Cardiovascular Medicine, Tokyo Medical and Dental University
  • Goya Masahiko
    Department of Cardiovascular Medicine, Tokyo Medical and Dental University
  • Sasaki Takeshi
    Department of Cardiovascular Medicine, Tokyo Medical and Dental University
  • Shiohira Shinya
    Department of Cardiovascular Medicine, Tokyo Medical and Dental University
  • Sekigawa Masahiro
    Department of Cardiovascular Medicine, Tokyo Medical and Dental University
  • Shirai Yasuhiro
    Department of Cardiovascular Medicine, Tokyo Medical and Dental University
  • Lee Kiko
    Department of Cardiovascular Medicine, Tokyo Medical and Dental University
  • Yagishita Atsuhiko
    Department of Cardiovascular Medicine, Tokyo Medical and Dental University
  • Maeda Shingo
    Advanced Arrhythmia Research, Tokyo Medical and Dental University
  • Takahashi Yoshihide
    Advanced Arrhythmia Research, Tokyo Medical and Dental University
  • Kawabata Mihoko
    Department of Cardiovascular Medicine, Tokyo Medical and Dental University
  • Hirao Kenzo
    Department of Cardiovascular Medicine, Tokyo Medical and Dental University

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Abstract

<p>Background: Transvenous lead extractions have been performed using 40-Hz laser sheaths. Recently, a new 80-Hz laser sheath became available, but only a few reports have compared the effectiveness of the 40- and 80-Hz laser sheaths. </p><p>Methods and Results: This study included 215 patients. Lead extractions using only laser sheaths were analyzed. The clinical characteristics, extraction parameters, and extraction tools were evaluated. The procedures were performed with 40-Hz sheaths in 150 patients (group 1: 270 leads) and 80-Hz sheaths in 65 (group 2: 99 leads). No statistically significant differences were observed in the clinical parameters except for sex. The mean implant duration was 95.3±86.0 and 78.2±56.8 months in groups 1 and 2, respectively (P=0.07). The respective mean laser time and number of laser pulses were 48.5±52.1 and 48.1±56.1 s (P=0.96) and 2,035.0±2,384.0 and 3,955.1±2,339.3 pulses (P<0.0001). Complete removal was achieved for 97.4% of the leads and in 98.0% in both groups (P=0.38). Major complications occurred in 2.0% and 3.1% of the patients in groups 1 and 2, respectively (P=0.94). </p><p>Conclusions: Transvenous lead extraction using high-frequency laser sheaths was as highly successful as with low-frequency laser sheaths in Japanese patients. </p>

Journal

  • Circulation Journal

    Circulation Journal 82 (12), 2992-2997, 2018-11-24

    The Japanese Circulation Society

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