February 03, 2021
MountainView Hospital physicians today performed the hospital’s first laser-assisted lead extraction, allowing for the safe and effective removal of leads that are attached to pacemakers and ICDs.
The laser-assisted lead extraction case was performed today (2/3/21) by Dr. Niuton Koide, Director of the Electrophysiology Department at MountainView Hospital and a board certified cardiac electrophysiologist with Las Vegas Heart Associates. Dr. Deepak Malhotra, cardiovascular and thoracic surgeon with MountainView’s Cardiovascular & Thoracic Surgery Associates, also assisted in the case.
Pacemakers and implantable cardioverter-defibrillators (ICDs) are crucial and life-saving devices for many that need to have their heartbeat controlled and assisted in beating more regularly. While pacemakers help with irregular heart rhythm (arrhythmia) by stimulating the heart to pump more quickly, ICDs prevent dangerous rapid heart rhythms.
These temporary and sometimes permanent devices are placed surgically by a physician to treat irregular heartbeat symptoms such as heart attack and heart failure often found in an aging population. As with any implantable device, at times there may be cause for removal. The addition of the laser-assisted lead extraction technology allows for the safe and effective removal of leads that are attached to pacemakers and ICDs.
“Over time, the leads that are thin wires that run between the pulse generator of the pacemaker and the heart, may need to be removed or replaced due to lead malfunction or damage, infection to tissue, venous occlusion, MRI requirements or for a device upgrade,” said Dr. Koide. “Due to scar tissue and adhesions forming, the leads may inadvertently attach to tissue, veins or the heart muscle making them especially difficult to remove.”
There are two types of lead extraction being offered at MountainView Hospital, including mechanical lead extraction and the newly added laser-assisted lead extraction, which is a minimally invasive approach using laser light to breakdown the fibrous scar tissue that forms around the leads.
“We are so proud that we now able to offer laser-assisted lead extractions for our patients,” said Julie Taylor, MountainView Hospital Chief Executive Officer. “This is just another tool in our arsenal of patient procedures that allows us to provide the highest level of care to our community.”
The cardiology program at MountainView Hospital is managed by experts including Dr. Koide as well as cardiothoracic and vascular surgeons; Michael G. Wood, MD, Deepak Malhotra, MD, James B. Daugharthy, MD, and Arnold Chung, MD. The surgeons are available with the electrophysiologist and typically assist the physician in these cases. Dr. Wood, Dr. Malhotra, Dr. Daugharthy and Dr. Chung are well versed in complications and concerns should any arise during the procedure to assist in patient care.
“This team approach with multi-disciplinary experts is integral in a successful program to safely and effectively care for our patients,” Dr. Koide said.
The procedure takes between two to four hours to complete and patients stay overnight for observation. Typically discharged home the next day, patients can return to light activity relatively soon after.