Clinical Trial Registration Information: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00547729.
An Implantable Left Atrial Pressure Sensor Lead Designed for Percutaneous Extraction Using Standard Techniques
Article first published online: 28 FEB 2013
©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.
Pacing and Clinical Electrophysiology
Volume 36, Issue 5, pages 570–577, May 2013
How to Cite
PRETORIUS, V., BIRGERSDOTTER-GREEN, U., HEYWOOD, J. T., HAFELFINGER, W., GUTFINGER, D. E., EIGLER, N. L., LOVE, C. J. and ABRAHAM, W. T. (2013), An Implantable Left Atrial Pressure Sensor Lead Designed for Percutaneous Extraction Using Standard Techniques. Pacing and Clinical Electrophysiology, 36: 570–577. doi: 10.1111/pace.12111
Financial Disclosures: The study was sponsored by St. Jude Medical, Sylmar, California. W. Hafelfinger and Drs Gutfinger and Eigler are employees of St. Jude Medical. Drs Birgersdoter-Green, Heywood, Love, and Abraham report receiving honoraria or consulting fees from St. Jude Medical or other companies that manufacture devices. The other authors report no conflict.
- Issue published online: 24 APR 2013
- Article first published online: 28 FEB 2013
- Manuscript Accepted: 31 DEC 2012
- Manuscript Revised: 23 NOV 2012
- Manuscript Received: 21 AUG 2012
- St. Jude Medical, Sylmar, California
- lead extraction;
- pacemaker infection;
- left atrial pressure monitoring
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.
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.
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.
The extraction of the LAP sensor lead was accomplished safely using standard techniques and equipment for percutaneously extracting pacemaker and defibrillator leads.