Successful extraction of right ventricular lead remnants using the FlexCath® steerable sheath.
In patients undergoing laser lead extraction, incomplete or failed lead removal occur in over 3 % of leads. Because the current available tools have limitations in reaching the right ventricle (RV), the procedure becomes challenging when the lead breaks and its fragments remain lodged in the RV. We describe two cases in which the FlexCath® steerable sheath, normally used in cryoballoon catheter ablation for atrial fibrillation, was useful in directing a bioptome to right ventricular lead fragments and thus allowing for complete lead extraction.
Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Sheikh Zayed Tower, 7125Q, Baltimore, MD, 21287, USA.
Tanyanan
T
Tanawuttiwat
Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Sheikh Zayed Tower, 7125Q, Baltimore, MD, 21287, USA.
Alan
A
Cheng
Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Sheikh Zayed Tower, 7125Q, Baltimore, MD, 21287, USA.
John
J
Rickard
Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Sheikh Zayed Tower, 7125Q, Baltimore, MD, 21287, USA.
Grant V
GV
Chow
Division of Cardiothoracic Surgery, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Christopher M
CM
Sciortino
Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Sheikh Zayed Tower, 7125Q, Baltimore, MD, 21287, USA. jbrinker@jhmi.edu.
Jeffrey
J
Brinker
D000368:Aged; D062906:Cardiac Catheters; D020878:Device Removal / Q000295:instrumentation*; D055119:Elastic Modulus; D004567:Electrodes, Implanted / Q000009:adverse effects*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005547:Foreign Bodies / Q000209:etiology* / Q000601:surgery*; D006352:Heart Ventricles / Q000293:injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
Lead extraction; Steerable sheath