Outcomes 2019 - Baylor Scott & White Heart and Vascular Hospital BSWHHVH_646_2019 Outcomes JOOMAG MOD | Page 22

22
Device lead extraction
Electrophysiologists on the medical staff
at Baylor Scott & White Heart and Vascular
Hospital – Dallas frequently see patients who
are referred to them with complex conditions
needing removal of leads because of electrical
malfunctions, blocked blood vessels or infection.
In most cases, the leads can be removed using a
catheter-based approach.
According to NSHN definition and criteria,
for the time period July 2018 - April 2019,
the infection rate for pacemaker implant
or replacement and for ICD implant or
replacement is 0.0011%, better than
reported national infection rate of 2.6%
after the initial procedure.
Left Atrial Appendage Occlusion (LAAO)
Leadless pacers
Electrophysiologists on the medical staff at
Baylor Scott & White Heart and Vascular Hospital
– Dallas are able to place the world’s smallest
pacemaker called the Micra™ Transcatheter
Pacing System in patients. Cardiologists on
the medical staff helped achieve US approval
for the commercial use of the Medtronic Micra
leadless pacemaker in 2016. The size of a nickel
or paperclip, the pacemaker represents the first
entry in what is a new class of slender, minimally
invasive pacemakers that rest entirely inside
the heart.
This type of leadless pacemaker is placed directly
into the right ventricle using a flexible tube the
size of a large drinking straw, which is advanced
into the heart from a small incision in the leg. Tiny
bits of metal on the end of the pacemaker hook
or screw into the heart tissue. This avoids the
need for traditional pacemaker insulated wires
called leads to deliver the pacemaker’s electric
pulses. Leads have been called the “Achilles’
heel” of pacemakers because they can wear out
and create infection risk.
Atrial fibrillation (AFib) can decrease the
heart’s pumping efficiency by as much as 30%.
Compromised pumping increases the risk of
clots forming in the heart chambers, particularly
the left atrial appendage (LAA). The LAA
is pouch-shaped and about the size of the
thumb. It is located on the top of the heart. LAA
occlusion generally eliminates the risk of stroke
without the need for blood thinners.
Electrophysiologists on the medical staff have
been successful with bringing the WATCHMAN™
device through clinical trials and post-FDA
approval. Approved by the FDA in 2016 after
years of research and clinical trials proving
its effectiveness, the device is now a more
commonly offered viable option for many
patients experiencing LAAO. The LAAO device is
designed to prevent blood clots that frequently
form in the LAA from traveling in the blood
stream to the brain, lungs and other parts of the
body. With this device, patients are generally
released from the hospital after 24 hours. Medical
follow-up continues over the course of time as
patients decrease their blood thinner medication
under the supervision of a cardiologist.
LAAOs performed
(FY19)
55