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