LONDON: Cleveland Clinic London is the first private hospital in the United Kingdom to have a cardiac device laser-lead system installed and successfully performing laser lead-extraction procedures of infected and malfunctioning cardiac device wires.
Pacing leads are insulated wires that run from the heart to a pacemaker or implantable cardioverter-defibrillator. If there is an infection or malfunction, it is necessary to remove them. Lead extraction is a complicated procedure because it requires navigating tough scar tissue that holds the lead in place.
Professor Aldo Rinaldi, consultant cardiologist at Guy’s & St Thomas’ NHS Foundation Trust and Cleveland Clinic London, led the electrophysiology team during the first procedure in October.
Cleveland Clinic London has now completed four successful laser lead-removal procedures since the system was installed. The first patients who benefitted from this procedure in the private sector in London presented with a combination of lead malfunctions and device-lead infections and recovered well after their procedures.
“Lead extraction for a cardiac device can be a lifesaving procedure. It requires a multidisciplinary team of cardiologists, cardiac surgeons, perfusionists and infection specialists,” said Professor Rinaldi. “Greater awareness of the symptoms and signs of device infection amongst patients and clinicians is essential for prompt diagnosis and treatment and are crucial to improve patient outcomes.”
An estimated 10,000-15,000 transvenous lead extractions are now performed yearly worldwide. While lead infections are uncommon, they should be treated by an experienced medical team. The most common reason for lead extraction is device infection that usually spreads to the lead from an infection of the blood (bacteremia). Heart valves may also become infected (infective endocarditis). Infection is not easily recognized but can lead to serious complications, including death, if not and treated promptly.
“Because device lead removal is a complex procedure, Cleveland Clinic London brings together a multidisciplinary team that manages the patient from diagnosis to recovery,” said Professor Bernard Pendergast, chair of Cardiology at Cleveland Clinic London. “The team brings together different clinical perspectives to the patient’s care for the best possible outcome.”
The laser lead-extraction service is the latest innovation available at Cleveland Clinic London since it opened in April 2022.