{"id":1135,"date":"2012-11-08T14:36:02","date_gmt":"2012-11-08T19:36:02","guid":{"rendered":"http:\/\/blogs.cooperhealth.org\/sjmedicalreport\/?p=1135"},"modified":"2012-11-08T14:36:02","modified_gmt":"2012-11-08T19:36:02","slug":"heart-institute-becomes-center-of-excellence-for-laser-assisted-lead-extraction","status":"publish","type":"post","link":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/2012\/11\/08\/heart-institute-becomes-center-of-excellence-for-laser-assisted-lead-extraction\/","title":{"rendered":"Heart Institute Becomes Center of Excellence for Laser-Assisted Lead Extraction"},"content":{"rendered":"<div>\n<div>\n<p><a href=\"http:\/\/www.cooperhealth.org\/departments-programs\/heart-institute\">The\u00a0 \u00a0Cooper\u00a0\u00a0 Heart\u00a0 \u00a0Institute<\/a>,\u00a0 \u00a0one of the premier arrhythmia management programs in the region, has recently been selected as one of 12 Centers of Excellence in the nation for laser-assisted endocardial lead extraction. Laser technology has transformed the safety and efficacy of transvenous\u00a0 cardiac\u00a0 pacing\u00a0 lead\u00a0 removal for \u00a0the \u00a0nearly \u00a010,000 \u00a0patients\u00a0 annually who \u00a0require extraction, a\u00a0 procedure \u00a0long associated\u00a0 with a \u00a0high \u00a0incidence of \u00a0life- threatening complications.<\/p>\n<\/div>\n<p>Institutions and teams are\u00a0 chosen \u00a0as Centers of Excellence by exhibiting the highest standard of practice, predictable outcomes, and world-class medical care in laser lead extraction and lead management.<\/p>\n<p>In addition, \u00a0a \u00a0Center of \u00a0Excellence\u00a0must \u00a0also include a\u00a0 multi-disciplinary health care team, led by the extracting electrophysiologist who manages all aspects of a patient\u2019s lead.<\/p>\n<p>Led by <a href=\"http:\/\/www.cooperhealth.org\/physicians\/john-andriulli-do\">John A. Andriulli, DO<\/a>, Director of the Cooper Electrophysiology Laboratory and Arrhythmia Device Program, the Cooper program provides outside physicians and their teams with didactic and observational training for laser lead extraction.<\/p>\n<p>\u201cCooper has a uniquely dedicated team that includes an electrophysiologist, a CT \u00a0surgeon, CT \u00a0anesthesiologist, perfusionist, \u00a0and \u00a0CT and \u00a0EP \u00a0nurses\u00a0\u00a0 to perform the laser-assisted lead extraction,\u201d says \u00a0Dr. \u00a0Andriulli. \u00a0\u201cOutcomes in\u00a0 lead extraction are closely linked to expertise and experience. At Cooper we have performed \u00a0over 150 extractions since our program \u00a0began\u00a0 in\u00a0 mid 2010, \u00a0without \u00a0a single serious complication, more than any other institution in New Jersey.\u201d<\/p>\n<p>The need for safe, effective lead extraction has risen as the\u00a0 use \u00a0of\u00a0 device implantation for arrhythmia management has increased. The Heart Rhythm \u00a0Society (HRS) Class I indications for lead extraction remain limited to:<\/p>\n<ul>\n<li>Infection,\u00a0\u00a0\u00a0 \u00a0defined\u00a0\u00a0\u00a0\u00a0 as\u00a0\u00a0\u00a0 \u00a0documented system \u00a0infection \u00a0evidenced by\u00a0 valvular endocarditis, lead endocarditis, or sepsis, as well as patients with evidence of pocket infection, pocket abscess, device erosion, and skin adherence.<\/li>\n<li>Life-threatening \u00a0arrhythmias\u00a0 secondary to retained leads or lead fragments in functional or non-functional leads.<\/li>\n<li>Endocardial \u00a0leads \u00a0that \u00a0due \u00a0to \u00a0their design, fracture or failure, may pose an immediate threat to the patient if left in place.<\/li>\n<li>Retained leads that interfere with the operation of implanted cardiac devices.<\/li>\n<\/ul>\n<div>\n<p>\u00a0Onsite cardiac surgery back-up is required to\u00a0 perform \u00a0laser lead extraction, and, until recently, all extraction procedures have been performed in the Cooper operating suites. However, extensive technological upgrades have been completed to enable\u00a0laser\u00a0 lead\u00a0 removal\u00a0 cases\u00a0 to \u00a0be\u00a0 moved from the Cooper operating suites to the new hybrid catheterization laboratory.<\/p>\n<div>\n<p>\u201cTo perform \u00a0lead \u00a0extraction \u00a0outside of the operating room setting, the lab needed to be retro-fitted to accommodate cardio-pulmonary bypass and advanced anesthesia capabilities,\u201d says Dr. Andriulli. \u201cCardiac anesthesia at Cooper is under the direction of\u00a0 <a href=\"http:\/\/www.cooperhealth.org\/physicians\/muhammad-muntazar-md\">Muhammad Muntazar, MD<\/a>, and staff, and is the finest in the Delaware Valley.\u00a0 The \u00a0combination of \u00a0exceptional anesthesia expertise, renovated laboratory facilities \u00a0and highly-trained \u00a0staff \u00a0provides a setting at Cooper to perform procedures on the most complex patients.\u201d<\/p>\n<p><strong>F<\/strong><strong>o<\/strong><strong>r more\u00a0<\/strong><strong>i<\/strong><strong>n<\/strong><strong>f<\/strong><strong>o<\/strong><strong>r<\/strong><strong>m<\/strong><strong>a<\/strong><strong>t<\/strong><strong>i<\/strong><strong>o<\/strong><strong>n\u00a0<\/strong><strong>a<\/strong><strong>b<\/strong><strong>o<\/strong><strong>u<\/strong><strong>t <\/strong><strong>l<\/strong><strong>a<\/strong><strong>s<\/strong><strong>e<\/strong><strong>r\u00a0 <\/strong><strong>lea<\/strong><strong>d <\/strong><strong>e<\/strong><strong>xt<\/strong><strong>r<\/strong><strong>a<\/strong><strong>c<\/strong><strong>t<\/strong><strong>i<\/strong><strong>o<\/strong><strong>n\u00a0<\/strong><strong>o<\/strong><strong>r to refer <\/strong><strong>a <\/strong><strong>pa<\/strong><strong>t<\/strong><strong>ie<\/strong><strong>n<\/strong><strong>t for <\/strong><strong>co<\/strong><strong>n<\/strong><strong>su<\/strong><strong>l<\/strong><strong>t<\/strong><strong>a<\/strong><strong>t<\/strong><strong>io<\/strong><strong>n<\/strong><strong>, please <\/strong><strong>c<\/strong><strong>a<\/strong><strong>l<\/strong><strong>l\u00a0<\/strong><strong>8<\/strong><strong>5<\/strong><strong>6<\/strong><strong>.<\/strong><strong>34<\/strong><strong>2<\/strong><strong>.<\/strong><strong>2<\/strong><strong>03<\/strong><strong>4<\/strong><strong>.<\/strong><\/p>\n<\/div>\n<p>&nbsp;<\/p>\n<\/div>\n<p><br clear=\"all\" \/>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The   Cooper   Heart   Institute,   one of the premier arrhythmia management programs in the region, has recently been selected as one of 12 Centers of Excellence in the nation for laser-assisted endocardial lead extraction. <\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,55,4],"tags":[],"class_list":{"0":"entry","1":"post","2":"publish","3":"author-dzarnosky","4":"has-excerpt","5":"post-1135","7":"format-standard","8":"category-featured","9":"category-new-initiatives","10":"category-news-updates"},"_links":{"self":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts\/1135","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/comments?post=1135"}],"version-history":[{"count":2,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts\/1135\/revisions"}],"predecessor-version":[{"id":1138,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/posts\/1135\/revisions\/1138"}],"wp:attachment":[{"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/media?parent=1135"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/categories?post=1135"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.cooperhealth.org\/sjmedicalreport\/wp-json\/wp\/v2\/tags?post=1135"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}