Cleveland Clinic London breaks new ground with cardiac lead extractions

Cleveland Clinic London has become the first private hospital in the UK to successfully perform laser lead-extraction procedures to remove infected and malfunctioning wires from cardiac devices.

Pacing leads are insulated wires that run between the heart and a pacemaker or implantable cardioverter-defibrillator. Extracting one of these leads in order to combat an infection or malfunction is a complicated procedure, requiring the careful navigation of tough scar tissue around the lead.

The most common reason for lead extraction is an infection of the blood that spreads to the lead (bacteremia). Heart valves may also become infected (infective endocarditis). Such infections are not easily recognised but can lead to serious complications, including death, if not treated promptly.

Prof Aldo Rinaldi of Cleveland Clinic London

“Lead extraction for a cardiac device can be a life-saving procedure. It requires a multidisciplinary team of cardiologists, cardiac surgeons, perfusionists and infection specialists,” said Professor Aldo Rinaldi, the consultant cardiologist at Cleveland Clinic London who led the electrophysiology team during the first procedure in October. “Greater awareness of the symptoms and signs of device infection among patients and clinicians is essential for prompt diagnosis and treatment and crucial to improving patient outcomes.”

Since the laser-lead system was installed, the clinic has now completed four successful laser lead-removal procedures. All four patients recovered well after their procedures.