Purpose: A new method for endocardial lead extraction, based on radiofrequency assistance, is proposed. The results obtained in the four initial cases are presented. Methods: Four patients with infected pacing leads were submitted to radiofrequency assisted lead extraction. Tined passive fixation leads were implanted in the right ventricle 8.5 to 18.8 (M = 12.9 ± 5.6) years before. Exhaustive continuous traction had been performed previously in four patients and failed to remove the leads. A Radionics RFG-3D Radio Frequency generator was connected to an anode fixed to the back of the patient. The cathode was the lead tip to be extracted. Up to three radiofrequency applications were performed in each patient. The energy released in each applications was up to 50 W during up to 60 seconds. This amount of energy was decided empirically based on the previous experience of the authors with radiofrequency ablation. No locking stylet was used. Results: Two patients had complete removal of their leads during RF application. In one patient radiofrequency energy disconnected the wire from tip of the lead, that rested in the myocardium. In another patient this procedures was not successful. No deaths or complications related to the technique occurred. Conclusion: RF can be used as an alternative method for lead extraction when laser assistance or countertraction cannot be used.
Pacemaker; Pacemaker; Electrodes; Electrodes; Prostheses-related infections; Radio waves
