Novel visualization of intracardiac pacing lead extractions: methodologies performed within isolated canine hearts.
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(R) 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.
Division of Cardiovascular Medicine, Ohio State University, 200 DAV HT&LNG, 473 W. 12th Ave., Columbus, OH 43210, USA.
Charles J
CJ
Love
Sarah E
SE
Ahlberg
Prasanga
P
Hiniduma-Lokuge
Scott
S
Brabec
Paul A
PA
Iaizzo
D000818:Animals; D013504:Cardiovascular Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D020878:Device Removal / Q000295:instrumentation / Q000379:methods*; D004285:Dogs; D004567:Electrodes, Implanted; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D006321:Heart / Q000033:anatomy & histology*; D007089:Image Enhancement / Q000295:instrumentation / Q000379:methods*; D066298:In Vitro Techniques; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*