February 03, 2021
A local cardiovascular expert is performing the first laser-assisted lead extraction at MountainView Hospital today. Niuton Koide, MD, FACC, board certified cardiac electrophysiologist at Las Vegas Heart Associates and the Director of the Electrophysiology Department at MountainView Hospital has been instrumental in adding the technology to the established program to manage complex lead extractions.
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 which 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,” said Dr. Koide.
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.
The cardiac lead management 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.