Target Audience

This activity is directed toward physicians, engineers and associated professionals who want to minimize the risk of implantable device therapy. Viewers will explore the pre, post and intra-operative choices facilitating safe and lifelong lead therapy.

Activity Design

Worldwide, over 4.3 million people have implantable pacemakers, ICDs or biventricular devices implanted, 1.8 million in the United States. The indications for devices are increasing and much of the major long-term morbidity associated with these devices are related to the lead, infectious and vascular complications. This webcast was captured from a live symposium held on May 5, 2005, covering major strategies for avoiding and treating these complications.

The webcast provides the following sequence of talks derived from the live symposium:

Welcome and Introduction
Bruce L. Wilkoff, MD

Implant Choices Techniques, Leads, & Timing
Charles Love, MD

Lead Performance Construction, Electrical & Extraction
Kenneth Ellenbogen, MD

Infection Prophylaxis, Recognition, Treatment
Bruce Wilkoff, MD

Extraction Mechanical-LASER-EDS, Risks, Timing
Charles Byrd, MD

Vascular Complications Acute & Chronic, Thrombosis, Occlusion, Stenting
Steven Kutalek, MD

Panel Discussion

Objectives

At the conclusion of this activity, the participant will be able to:

1. Select the timing, location and techniques for surgical intervention promoting lifelong lead therapy.
2. Define the characteristics of lead construction that promote reliable and low-risk leads.
3. Recognize device infection and the choices that reduce the incidence and optimize therapy.
4. Identify the extraction options and how surgical options including extraction can reduce lifelong lead therapy risk.
5. Evaluate the risk of vascular complications with device therapy and how lead extraction minimizes lifelong device therapy risk.

Activity Director

Bruce L. Wilkoff, MD
Professor of Medicine
The Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
Director, Cardiac Pacing and Tachyarrhythmia Devices
Medical Director, Clinical Electrophysiology Research
Staff cardiologist, Department of Cardiology
Section of Cardiac Pacemakers and Electrophysiology
The Cleveland Clinic Foundation
Cleveland, OH

Author / Faculty

Charles L. Byrd , MD; Kenneth A. Ellenbogen, MD;
Steven P. Kutalek, MD; Charles J. Love, MD

Faculty Disclosure

In accordance with the Standards for Commercial Support issued by the Accreditation Council for Continuing Medical Education (ACCME), The Cleveland Clinic Foundation Center for Continuing Education requires resolution of all faculty conflicts of interest to ensure CME activities are free of commercial bias.

The following faculty have indicated that they may have a relationship, which in the context of their presentation(s), could be perceived as a potential conflict of interest:

Kenneth A. Ellenbogen, MD
Grant/Research Support: Guidant, Medtronic, and St. Jude Medical
Consultant: Guidant, Medtronic, and St. Jude Medical
Speaker’s Bureau: Guidant, Medtronic, and St. Jude Medical

Steven P. Kutalek, MD
Grant/Research Support: ELA Medical, Guidant, Medtronic, St. Jude Medical
Consultant: Guidant

Bruce L. Wilkoff, MD
Grant/Research Support: Guidant, Medtronic, and St. Jude Medical
Consultant: Guidant, Medtronic, St. Jude Medical, Spectranetics and Cook Vascular

Charles L. Byrd, MD has not completed the Faculty Certification Form and may have a relationship which, in the context of his presentation could be perceived as a potential conflict of interest.

The following faculty has indicated he/she has no relationship which, in the context of their presentation(s), could be perceived as a potential conflict of interest:

Charles J. Love, MD