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Lead Management & Lead Extraction

Sessions

Lead Management Sessions

019 How To Manage Device Leads and Recalls

052 Managing Lead Nightmares

117 What Do I Do With This Lead?

145 Breaking Bad - How to Diagnose, Avoid and Mange Lead Issues

Lead Extraction Sessions

040 Rapid Fire: Challenging CRT Cases

048 Rapid Fire Cases: Clinical EP from Lab to Floor and Beyond

112 Practical Approach to the Use of New Tools and Techniques in Complex Ablation

and Device Implantation Procedures

125 CRT Boot Camp - Tips and Tricks for Implantation and Follow-up

153 Special Considerations for Challenging Lead Extractions

LEAD MANAGEMENT

How-To

019 How To Manage Device Leads and Recalls

Thursday, May 11, 2017 8:00 AM - 9:30 AM

Session Description: This session will focus on lead management issues from spotting lead

fractures or insulation breaks, remote monitoring and early recognition of potential problems

to discussion of when to extract.

Learning Objectives 1: To discuss indication for extraction of recalled leads

Learning Objectives 2: To outline standardized follow up of leads/devices with appropriate

recognition of impending problems

Learning Objectives 3: To identify markers of impending lead failure early by remote

monitoring

Presentation

Name

Chair

Helen M. McFarland, RN.

University of Michigan, Ann

Arbor, MI

Why Do Leads Fail? What Have We Learned From

Previous Recalls and Industry Reports

Rutuke K. Patel, PA-C. Temple

University Hospital, Philadelphia,

PA

Remote Monitoring of CIEDs-Interpreting Lead Trends and

Other Diagnostics to Catch Problems Early

Lynn M. Brewer, CCDS. The

Heart Group of Lancaster

General Health, Lancaster, PA

Indications for Lead Extraction of the Recalled Lead-Is

There New Information Out There?

Scott Kruchan, RN, BSN, CCDS.

Cleveland Clinic, Cleveland, OH

Lead Extraction-Patient and Lab Prep, Risks, Reimplant

Considerations

James Kulig, PA-C. Brigham and

Women's Hospital, Boston, MA

Case Based Tutorial

052 Managing Lead Nightmares

Thursday, May 11, 2017 4:30 PM - 6:00 PM

Session Description: Interactive case based session where expert faculty will present cases

from their practices to illustrate aspects of complex CIED lead issues and management.

Learning Objectives 1: To discuss approaches to complex CIED lead management.

Learning Objectives 2: To outline steps for optimal CIED lead management

Learning Objectives 3: To identify options related to complex CIED lead management.

Presentation

Name

Chair

Steven P. Kutalek, MD, FHRS,

CCDS. Drexel University College of

Medicine - Hahnemann University

Hospital, Philadelphia, PA

Chair

Thorsten Lewalter, MD, PhD.

Hospital Munich-Thalkirchen -

Peter Osypka Heart Center,

Munich, Germany

A Patient With Defibrillator Lead Noise - I Wish I Knew

Now What I Didn't Know Then

Andrew E. Epstein, MD. University

of Pennsylvania, Philadelphia, PA

A patient with an ICD and ineffective for shock therapy

Francois Philippon, MD, FHRS.

Quebec Heart Institute, Ste-foy,

QC, Canada

A patient with complex venous access - how I solved the

problem.

Maria Grazia Bongiorni, MD.

University Hospital of Pisa, Pisa,

Italy

A patient with failed optimal LV lead placement - what

now?

Seth J. Worley, MD, FHRS. The

Heart and Vascular Institute of

Lancaster General Hospital,

Lancaster, PA

Case Based Tutorial

074 Case-based Discussion - What Do I Do With This Lead?

Friday, May 12, 2017 8:00 AM - 9:30 AM

Session Description: This case-based discussion will answer the question, what do I do with this

lead?

Learning Objectives 1: To discuss approaches to managing chronically implanted leads.

Learning Objectives 2: To outline steps involved with deciding on lead extraction.

Learning Objectives 3: To identify options for chronic lead management.

Presentation

Name

Chair

Peter J. Kudenchuk, MD, FHRS,

CCDS. University of Washington,

Seattle, WA

Chair

Sergio G. Thal, MD, CEPS.

Southern Arizona VA Health Care

System, Tucson, AZ

Lead management in inpatients with complex anatomy

where extraction may not be the best option

Kimberly Selzman, MD, MPH,

FHRS. Salt Lake City VA Hospital,

Salt Lake City, UT

A lead extraction case where the surgeon needs to be

involved in operative planning - Surgical Perspective

Charles Kennergren, MD, PhD,

FHRS. Sahlgrenska University

Hospital, Gothenburg, Sweden

Should an SVC balloon be the new standard of care? A

case illustration.

Jude Clancy, MD. Yale University

School of Medicine, New Haven,

CT

How device diagnostics can aid in making good decisions

- a case where the lead is not the issue.

Charles Swerdlow, MD, FHRS,

CCDS. Cedars-Sinai Medical

Center, Los Angeles, CA

How-To

145 Breaking Bad - How to Diagnose, Avoid and Mange Lead Issues

Saturday, May 13, 2017 8:00 AM - 9:30 AM

Session Description: How to diagnose, avoid and mange CIED lead issues.

Learning Objectives 1: To discuss how to evaluate lead integrity

Learning Objectives 2: To outline the steps involved in lead evaluation

Learning Objectives 3: To identify features that predict lead survival and failure

Presentation

Name

Chair

Fred M. Kusumoto, MD, FHRS.

Mayo Clinic, Jacksonville, FL

Chair

John A. Andriulli, DO, CCDS.

Cooper University Hospital,

Camden, NJ

How I use device diagnostics to make the best decisions

for my CIED patients.

Charles Swerdlow, MD, FHRS,

CCDS. Cedars-Sinai Medical

Center, Los Angeles, CA

What implanters should know about lead design to

minimize longterm complications.

John R. Helland, BSME. St. Jude

Medical, Sylmar, CA

My implant technique pearls for optimal longterm lead

performance.

Raghuveer Dendi, MD. University

of Kansas Medical Center, Kansas

City, KS

My approach to assessing and managing lead

externalization.

Madhu Reddy, MD. University of

Kansas Medical Center, Kansas

City, KS

LEAD EXTRACTION

Rapid Fire Cases

C-040 Rapid Fire: Challenging CRT Cases

Thursday, May 11, 2017 10:30 AM - 12:00 PM

Session Description: This session will cover 6 challenging CRT related cases. An expert panel will

review treatment options and offer insightful commentary.

Learning Objectives 1: To discuss the management of infected leads in patients with anatomical

challenges.

Learning Objectives 2: To outline data regarding the use of CRT-P vs CRT-D.

Learning Objectives 3: To identify patients that may benefit from cardiac resynchronization

therapy.

Presentation

Name

Chair

Charles A. Henrikson, MD, FHRS.

Oregon Health and Science

University, Knight Cardiovascular

Institute, Portland, OR

My 80 yo patient with CHB, EF < 35%, DDD pacemaker

is due for replacement- CRT-P or CRT-D?

J. Rod Gimbel, MD. Case Western

Reserve University, Cleveland, OH

Panel Discussion Q & A

My pacemaker patient is referred for upgrade to CRT-D

- extract or cap the old lead?

Uma N. Srivatsa, MD, FHRS.

University of California - Davis

Medical Center, Sacramento, CA

Panel Discussion Q & A

My patient referred for CRT has a RBBB -what device

should I implant?

Ashish A. Bhimani, MD. University

of Texas Galveston, Galveston, TX

Panel Discussion Q & A

My patient referred for ICD and lead extraction with

staph sepsis has an epicardial LV lead - what to do?

Dina Sparano, MD. University

Hospitals Case Medical Center,

Cleveland, OH

Panel Discussion Q & A

Panel Discussion Q & A

My patient with ESRD, left AV fistula, right sided CRT-D

is dependent and infected? What is my approach?

Joshua M. Cooper, MD, FHRS.

Temple University Hospital,

Philadelphia, PA

Panel Discussion Q & A

Panelist

Emile G. Daoud, MD, FHRS. The

Ohio State University, Columbus,

OH

Panelist

Jane Chen, MD, FHRS. Orlando VA

Medical Center, Orlando, FL

Panelist

Mina K. Chung, MD, FHRS.

Cleveland Clinic, Cleveland, OH

Case Based Tutorial

048 Rapid Fire Cases: Clinical EP from Lab to Floor and Beyond

Thursday, May 11, 2017 4:30 PM - 6:00 PM

Session Description: Case based interactive format provides review of clinical EP topics

including complication recognition and treatment, syncope, and lead extraction.

Learning Objectives 1: To discuss appropriate indications and risks/benefits of lead extraction.

Learning Objectives 2: To outline appropriate management of syncope.

Learning Objectives 3: To identify the signs of EP lab complications and discuss treatment.

Presentation

Name

Chair

Heather M. Ross, DNP, ANP-BC,

FHRS, CCDS, CEPS. Arizona

Arrhythmia Consultants,

Scottsdale, AZ

Chair

Aileen M. Ferrick, RN, PhD, ACNP,

FHRS. Westchester Medical

Center, Hawthorne, NY

EP procedure complication

Justina Antonio, PA-C. Monetfiore

Medical Center, Bronx, NY

Syncope/POTS/IST

Andrea Schell, PA-C. Hospital of

the University of Pennsylvania,

Philadelphia, PA

Hemodynamic monitoring/support in EP lab

Erin E. Flatley, BSN, MSN.

University of Chicago, Chicago, IL

Lead Extraction Case

David J. Orenstein, Biomedical

Technology. Hadassah Medical

Center, Jerusalem, Israel

Panelist

Gerilynn M. Schott, MSN, CRNP.

University of California - San

Francisco, San Francisco, CA

Panelist

James Armstrong, PA-C. St.

Elizabeth's Medical Center,

Boston, MA

Panelist

Monica Pammer, PA-C. University

of Pennsylvania, Philadelphia, PA

Featured Symposium

C-112 Practical Approach to the Use of New Tools and Techniques in Complex Ablation and

Device Implantation Procedures

Friday, May 12, 2017 8:00 AM - 9:30 AM

Session Description: With expanding techniques and tools for complex ablation and device

implantation procedures, a variety of different approaches may be adopted at different

centers. The “tricks of the trade” will be shared from around the globe in this joint session.

Learning Objectives 1: To describe use of new techniques and tools for complex ablation

procedures for ventricular tachycardia and atrial fibrillation

Learning Objectives 2: To illustrate techniques of implanting leadless pacing systems while

minimizing complications

Learning Objectives 3: To identify contemporary approaches and the latest tools for lead

extraction

Presentation

Name

Chair

Andrea Sarkozy, PhD, MD. University

Hospital of Antwerp, Edegem,

Belgium

Chair

Andrea M. Russo, MD, FHRS. Cooper

University Hospital, Camden, NJ

My Approach: Use of New Catheter Technology During

Ablation of Ventricular Arrhythmias

Usha B. Tedrow, MD, MS, FHRS.

Brigham and Women's Hospital,

Boston, MA

My Approach: Use of New Catheter Technology During

Ablation of Ventricular Arrhythmias

Sabine Ernst, MD. Royal Brompton

Hospital, London, United Kingdom

My Approach: Leadless Pacemaker Implantation

Theofanie Mela, MD. Massachusetts

General Hospital, Boston, MA

My Approach: New Tools for Lead Extraction

Maria Grazia Bongiorni, MD.

University Hospital of Pisa, Pisa, Italy

Panelist

Cecilia M. Linde, MD, PhD. Karolinska

Institute, Stockholm, Sweden

Panelist

Jeanne E. Poole, MD, FHRS, CCDS.

University of Washington, Seattle,

WA

Case Based Tutorial

125 CRT Boot Camp - Tips and Tricks for Implantation and Follow-up

Friday, May 12, 2017 4:30 PM - 6:00 PM

Session Description: This session will discuss tips and tricks for CRT implantation and follow-up.

This highly educational session will provide practical suggestions for trouble shooting.

Learning Objectives 1: To identify implantation related problems in CRT patients.

Learning Objectives 2: To discuss how to manage complications.

Learning Objectives 3: To discuss how follow-up

Presentation

Name

Chair

J. Lacy Sturdivant, MD. Medical

University of South Carolina,

Mount Pleasant, SC

Chair

Bulent Gorenek. Eskisehir

Osmangazi University Hospital,

Eskisehir, Turkey

I can't implant the LV lead in an adequate, stable position

Jagmeet P. Singh, MD, PhD,

FHRS. Massachusetts General

Hospital, Boston, MA

Everything went well but my patient is not responding

John P. Boehmer, MD. Penn

State College of Medicine and

Surgery, Hershey, PA

How to reduce the number of appropriate shocks in a

patient with CRT-D

Bulent Gorenek. Eskisehir

Osmangazi University Hospital,

Eskisehir, Turkey

Coronary sinus lead extraction

Roger G. Carrillo, MD, FHRS,

CCDS. University of Miami,

Miami, FL

Core Curriculum

153 Special Considerations for Challenging Lead Extractions

Saturday, May 13, 2017 10:30 AM - 12:00 PM

Session Description: The purpose of this session will be to review the approach to challenging

lead extractions. This session is intended for audiences that routinely perform extractions.

Potential session talks:1. When not to extract2. Leads that require special consideration during

extraction3. Advanced imaging: how to recognize leads within the lumen or adherent to SVC

wall4. Managing complications: alternative approaches to vascular tears with vascular stenting.

5. Debate: Pro vs. Con - To Pull or not to Pull: Managing redundant leads

Learning Objectives 1: To identify high risk features that should sway extractors away from

recommending percutaneous lead extraction

Learning Objectives 2: To identify potentially challenging leads that require special preparation

during percutaneous extraction

Learning Objectives 3: To discuss pros and cons of managing redundant leads - knowing when

extraction makes most sense

Presentation

Name

Chair

Roger G. Carrillo. University of

Miami, Miami, FL

Chair

Jonathan P. Piccini, MD, MHS,

FHRS. Duke University Medical

Center, Durham, NC

Concerning Clinical features: when to defer percutaneous

extraction

Bruce L. Wilkoff. Cleveland Clinic,

Cleveland, OH

Using imaging to guide percutaneous extraction

Robert D. Schaller, DO. Hospital

of the University of Pennsylvania,

Philadelphia, PA

Leads that require special consideration during extraction

Charles A. Henrikson. Oregon

Health and Science University,

Knight Cardiovascular Institute,

Portland, OR

Managing Redundant Leads - When not to Extract

Laurence M. Epstein. Brigham

and Women's Hospital, Boston,

MA

What We Can Learning from Measuring Extractor’s

Performance

JoEllyn C. Moore, MD.

Minneapolis Heart Institute,

Minneapolis, MN