Newmarket, Ontario (May 1, 2008) Southlake Regional Health Centre has furthered its unique position in the cardiac community by recently becoming one of only a few hospitals in Canada to perform a highly specialized, minimally invasive procedure to remove cardiac leads from a patient’s heart.
A cardiac lead is a wire that connects an implantable cardioverter defibrillator (ICD) or pacemaker to the interior of the heart—devices that serve to maintain normal or control abnormal rhythms of the heart. Removal of a cardiac lead is essential when the lead is damaged; is interfering with blood flow to the heart; is non-functioning; or where there is an infection at the implant site of the lead.
This very delicate procedure is being performed by Drs. Yaariv Khaykin and Atul Verma, who last year brought international attention to Southlake when they became the first physicians worldwide to perform a new procedure that vastly improves treatment to patients with debilitating arrhythmias or irregular heartbeats.
Beaverton resident Larry Jerome was the first patient to receive this latest lifesaving cardiac procedure at Southlake. “I have a long history of successful treatment at Southlake,” said Mr. Jerome, “It didn’t enter my mind to be nervous about this procedure, even if I was the first to receive it.” After the successful lead extraction, Mr. Jerome was up and walking around the same day. “I have great faith in Southlake and especially in the Cardiac team. My family and I are in the process of moving but we made sure to stay within the catchment area for Southlake – I can’t imagine receiving major treatment at any other hospital,” Mr. Jerome added.
Using a Spectranetics Laser System, Dr. Khaykin removed Mr. Jerome’s cardiac leads in order to cure an infection that had developed at the implant site. As is typical with removal of cardiac leads, the procedure was made challenging by the fact that fibrous tissue had grown around the leads and adhered to them.
“Once someone has their leads in place for over 6 months, particularly in the case of ICD leads, the leads get covered by scar tissue and become part of the vein wall,” said Dr. Khaykin. “In order to remove the leads, a laser is used to safely separate the lead from the vessel wall.
The laser delivers high intensity light to gently dissolve the scar tissue into particles that are easily absorbed into the blood stream. The procedure is highly intricate and requires the cooperation of various members of the cardiac team, including surgeons, anesthetists, cardiac perfusionists, nurse practitioners, registered nurses, and respiratory therapists. “In order to safely perform this procedure, it is necessary to have a cardiac team and operating space available for backup in case of life threatening complications,” explained Dr. Zaev Wulffhart, Medical Director, Heart Rhythm Program. “Fortunately, both procedures performed at Southlake to date have gone smoothly and the back-up support of the surgical team has not been required.”
The procedure takes approximately 90 minutes to complete. The recovery period is remarkably short considering the high intensity of the procedure allowing the patient to be up and walking within hours and a new device implanted within 7 to 10 days.
Historically all Ontario patients with this condition were required to travel to the Cleveland Clinic in the United States for cardiac lead removal. In recent years, the service became available at two Ontario teaching centres. Thanks to a generous donation to the Southlake Foundation from a long-time donor who wishes to remain anonymous, Southlake was able to acquire the necessary laser tools and become one of only a few hospitals in Canada to provide this lifesaving procedure. It is expected that approximately 25 procedures using this new technology will be performed each year at Southlake.