First Laser Lead Extraction at Scripps La Jolla Is a Success

New procedure safely removes defective implantable defibrillator lead

Some unique circumstances surrounded the first laser lead extraction procedure at Scripps Memorial Hospital La Jolla. The procedure was performed by Steven Higgins, MD, who happened to be celebrating his birthday that day. He patient was also named Dr. Higgins—Dr. James Higgins.

Dr. Higgins (patient) had a life-saving implantable defibrillator inserted at Scripps Mercy San Diego in 2008 by Dr. Joseph Stein. On Nov. 2, the device helped save his life by converting life-threatening ventricular fibrillation with an automatic shock. However, in the emergency room a problem was uncovered. The device did not appropriately sense and treat the fibrillaiton as quickly as it should have. The lead wire connected to the device was on a health safety alert with concerns about insulation erosion. If the patient had another episode, the device might fail which could be fatal.

On Nov. 6, Dr. Steven Higgins, chairman of the cardiology department at Scripps La Jolla, removed the defective lead and replaced it with a new one. Even though he has performed hundreds of pacemaker and defibrillator lead extractions, this was the first time he used a new laser tool to perform the complex lead extractions. The tool uses a circular laser known as a Spectranetics Excimer laser. The laser breaks up the scar tissue that surrounds the lead so that it can be more easily removed.

A multidisciplinary heart care team

The laser lead extraction program is also an example of this team effort as it is jointly led by Drs. Higgins, John Rogers and Sam Baradarian. In addition to the physicians, this procedure required a multidisciplinary team of staff and administrators from the cardiac electrophysiology and cardiac surgery departments. More than 20 people were needed to coordinate this effort.

Upon his discharge, just two days after the procedure, Dr. James Higgins noted “I had complete faith in my Scripps team. Now, I need to get back to my exercise training!”

As for Scripps La Jolla’s Dr. Higgins, he says it made his special day that much more so. “This is the best birthday present ever. How many people can say they saved a life on their birthday?”

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Lisa Ohmstede
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