Lasers help extract pacemaker leads safer

Patients with extensive scarring around defective pacemaker leads can now stay in Fort Myers to have them repaired.

Three weeks ago, Florida Heart Associates Dr. James Sensecqua began performing laser extractions on the leads - a flexible wire that connects the pacemaker to the heart muscle. The leads need to be replaced when a recall has been issued, or after time has passed because the wires break down or deteriorate. Built-up scar tissue can also block the lead, which would also result in it needing to be removed and replaced.

"We have extracted leads for years, but we just started to do it with the laser," he said. "The laser passes over the lead and it comes out easily. It takes less time and it is safer."

Previously, doctors were inserting a catheter in the groin to get to the leads, then removing them. If there were complications and the muscle was torn during the procedure, patients had to be rushed in for open heart surgery.

When there was scarring around the heart muscle where the leads were placed, cases were referred to Fort Lauderdale.

Those cases can now be addressed locally.

Ryan Youngblood, registered cardiovascular technician at Southwest Florida Regional Medical Center, said a laser catheter is inserted over the leads that will be removed.

"It uses a laser type catheter to remove the lead from the tissue inside of the heart. The device goes right over the lead. It burns scar tissue as you go down to the lead. The puncture is made in the axillary or subclavian vein," he said. "The first procedure took 35 minutes."

There are lasers at both Southwest Florida Regional Medical Center, where Sensecqua performed the first removal, and also at HealthPark Regional Medical Center. The lasers are used for other procedures, as well.

Sensecqua went to the Cleveland Clinic in Ohio to learn how to remove the leads with a laser and finished the course in November.

He has two patients undergoing the procedure this week.

Patients are given anesthesia and spend the night at the hospital, where doctors monitor them.