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.

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.

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

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1. View the webcast.
2. Complete CME evaluation form.
3. Register for AMA PRA Category 1 credit.
4. Print personalized CME certificate.

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

Charles L. Byrd , MD
Director, Electrophysiology Institute,
Cardiothoracic Surgery
North Broward General Medical Center
Fort Lauderdale, FL

Kenneth A. Ellenbogen, MD
Professor of Medicine, Cardiology
Director, Clinical Cardiac Electrophysiology and Pacing
Virginia Commonwealth University
McGuire Veterans Administration Medical Center
Richmond, VA

Steven P. Kutalek, MD
Associate Professor of Medicine
Associate Chief, Cardiology
Director, Cardiac Electrophysiology
Drexel University College of Medicine
Philadelphia, PA

Charles J. Love, MD
Associate Professor, Clinical Internal Medicine
Director, Arrhythmia Device Services Ohio
State University Division of Cardiology
Columbus, OH

FACULTY DISCLOSURE
Current guidelines state that participants in CME activities should be made aware of any affiliation or financial interest that may affect the speaker’s presentation(s). The following faculty have indicated having a relationship, which, in the context of their section, 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 J. Love, MD has indicated he has no relationship, which, in the context of his presentation, could be perceived as a potential conflict of interest.

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 Cleveland Clinic Foundation Center for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Cleveland Clinic Foundation Center for Continuing Education designates this educational activity for a maximum of 2 Category 1 credits toward the AMA Physician’s Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.

This activity may be submitted for American Osteopathic Association Continuing Medical Education credit in Category 2.

The information in this educational activity is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition. The viewpoints expressed in this CME activity are those of the authors/faculty. They do not represent an endorsement by The Cleveland Clinic Foundation. In no event will The Cleveland Clinic Foundation be liable for any decision made or action taken in reliance upon the information provided through this CME activity.

The Cleveland Clinic Center for Continuing Education acknowledges an educational
grant for support of this activity from:

This CME activity was produced by The Cleveland Clinic Foundation Center for Continuing Education and UNITECH Communications^®.

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