Controversies in Lead Extraction

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Sunday, April 3, 2:30-3:30 PM

There are several trends in cardiac device implantation. More people are receiving devices; more devices need battery changes; and there are many device failures or recalls. Each of these trends increases the chance that lead extraction will have to be performed.

In a study last June from Brigham and Women's Hospital in Boston, researchers reported the failure rate of the Sprint Fidelis defibrillator lead has increased to a range greater than initially appreciated with emerging evidence of an accelerating rate of fracture. They also noted that leads with longer implant durations are associated with the use of countertraction sheath assistance.

Lead extraction has become a specialty in its own right. The procedure is associated with risk and the higher the volume of the operator, the better the technique. But even less volume-heavy EPs should at least feel comfortable in knowing some of the finer points of debate regarding lead extraction. In this session, they will hear panelists discuss various cases, the challenges, the solutions, and the best way to proceed.

Speaker Information

  • Laurence Mark Epstein, MD, Brigham and Women's Hospital, Boston -- Chair
  • Avi Fischer, MD, The Mount Sinai Medical Center, New York City -- Case Presenter
  • Joshua M. Cooper, MD, Hospital of the University of Pennsylvania, Philadelphia -- Panelist
  • Samir F. Saba, MD, University of Pittsburgh Medical Center -- Panelist
  • Bruce L. Wilkoff, MD, Cleveland Clinic -- Panelist