NY Times: difficult decisions about Sprint Fidelis leads

Many patients with Sprint Fidelis leads, along with their doctors, face difficult decisions, according to a feature story in today’s New York Times. Reporter Barry Meier writes that “thousands of those patients may face risky surgical procedures to remove and replace” the leads.

Meier reports that 4 patients have already died during Sprint Fidelis lead extraction procedures, and that some “experts fear that the toll could quickly rise if such procedures are not performed by skilled doctors at medical centers that have performed many of the operations.”  The article quotes the Cleveland Clinic’s Bruce Wilkoff, who says some physicians who are performing extraction procedures “don’t meet the criteria.”

Another expert highlighted in the article is the Brigham and Women’s Hospital’s Laurence Epstein, who specializes in lead extraction. When replacing a defibrillator Epstein also replaces Sprint Fidelis leads, even if they are intact, according to the article. By contrast, Wilkoff will reattach undamaged Sprint Fidelis leads when replacing a defibrillator.

Later this year the Heart Rhythm Society is expected to release guidelines about lead extractions. Meier reports that they guidelines will say that physicians should “perform at least 30 removals under the supervision of an experienced extraction surgeon before operating solo.”

Epstein is quoted at the end of the article: “Of all the procedures I do, extraction probably has by far the largest learning curve.”

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