title: An implantable left atrial pressure sensor lead designed for percutaneous extraction using standard techniques.
abstract: BACKGROUND
  An implantable left atrial pressure (LAP) monitoring system for guiding the management of patients with advanced heart failure has the potential to require extraction, particularly in the setting of infection. The LAP sensor lead was designed to be suitable for ease of percutaneous extraction using standard techniques for extracting pacemaker and defibrillator leads. The clinical experience, to date, with percutaneous extraction of the LAP sensor lead is presented.
  
  
  METHODS
  A total of 82 patients underwent successful implantation of the LAP sensor lead using transseptal catheterization. Five patients of the 82 patients during a cumulative follow-up period of 267 patient-years (median of 2.9 years/patient) underwent percutaneous extraction using manual traction with a locking stylet and/or an excimer laser sheath to bore through adhesions. The distal fixation anchors of the LAP sensor lead are designed to fold forward during extraction so that the sensor module can easily separate from the interatrial septum.
  
  
  RESULTS
  Percutaneous extraction of the LAP sensor lead was accomplished successfully in all five patients with no embolic events, vascular tears, perforations, or other complications requiring surgical intervention. Manual traction alone was sufficient to detach the LAP sensor lead from the interatrial septum in all cases. Use of the excimer laser sheath was needed in selected cases to bore through scar tissue within the venous insertion site, but not within the heart.
  
  
  CONCLUSIONS
  The extraction of the LAP sensor lead was accomplished safely using standard techniques and equipment for percutaneously extracting pacemaker and defibrillator leads.
authors: Department of Cardiothoracic Surgery, University of California San Diego, La Jolla, CA 92093-7892, USA. gpretorius@ucsd.edu
authors: Victor
authors: V
authors: Pretorius
authors: Ulrika
authors: U
authors: Birgersdotter-Green
authors: J Thomas
authors: JT
authors: Heywood
authors: Werner
authors: W
authors: Hafelfinger
authors: Dan E
authors: DE
authors: Gutfinger
authors: Neal L
authors: NL
authors: Eigler
authors: Charles J
authors: CJ
authors: Love
authors: William T
authors: WT
authors: Abraham
mesh_terms: D000368:Aged; D001795:Blood Pressure Determination / Q000295:instrumentation* / Q000379:methods; D020878:Device Removal / Q000379:methods*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006325:Heart Atria / Q000503:physiopathology* / Q000601:surgery*; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014160:Transducers, Pressure; D016896:Treatment Outcome