Author + information
- Received July 12, 2017
- Revision received November 30, 2017
- Accepted December 7, 2017
- Published online February 19, 2018.
- Saumya Sharma, MD∗ (, )
- Ijeoma A. Ekeruo, MD,
- Nikita P. Nand, MD,
- Ajay Sundara Raman, MD,
- Xu Zhang, PhD,
- Sunil K. Reddy, MD and
- Ramesh Hariharan, MD
- Department of Cardiac Electrophysiology, The University of Texas Health Science Center at Houston, Houston, Texas
- ↵∗Address for correspondence:
Dr. Saumya Sharma, Department of Cardiac Electrophysiology, The University of Texas Health Science Center at Houston, Texas, 6400 Fannin Street, Suite 2550, Houston, Texas 77030.
Objectives The goal of this study is to assess the safety and efficacy of mechanical lead extraction utilizing the Evolution system.
Background Compared with other techniques commonly used for lead extraction, data regarding the safety and efficacy of mechanical lead extraction using the Evolution system is limited and needs further evaluation.
Methods Between June 1, 2009 and September 30, 2016, we retrospectively analyzed 400 consecutive patients who exclusively underwent mechanical lead extraction utilizing the Evolution system.
Results A total of 400 patients underwent mechanical lead extraction of 683 leads. Mean age of extracted leads was 6.77 ± 4.42 years (range 1 to 31 years). The extracted device system was an implantable cardioverter-defibrillator in 274 patients (68.5%) and a pacemaker system in 126 patients (31.5%). Complete lead removal rate was 97% with a clinical success rate of 99.75%. Incomplete lead removal with <4-cm remnant was associated with older leads (lead age >8 years). Failure to achieve clinical success was noted in 1 patient (0.25%). Cardiac papillary avulsion, system-related infection, and cardiac tamponade were the major complications noted in 6 patients (1.5%). Minor complications were encountered in 24 patients (6%), of which hematoma requiring evacuation was the most common minor complication. There were no patient deaths.
Conclusions In our single-center study, lead extractions utilizing the Evolution mechanical lead extraction system were safe and effective and resulted in high clinical and procedural success, with low complication rates and no fatalities.
Dr. Sharma has received speaking fees from Cook Medical. Dr. Reddy has received consulting/teaching fees from Biosense Webster, St. Jude, Abbott, and Biotronik. Dr. Hariharan has received speaking fees from Cook Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
All authors attest they are in compliance with human studies committees and animal welfare regulations of the author’s institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received July 12, 2017.
- Revision received November 30, 2017.
- Accepted December 7, 2017.
- 2018 American College of Cardiology Foundation
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