In health care, just like the old saying goes, it’s often true that two heads are better than one.

That’s why patients with pacemakers and implantable cardioverter defibrillators (ICDs) who experience device complications or malfunctions can now benefit from a new program that pairs a cardiovascular surgeon and an electrophysiologist together in a single multidisciplinary clinic.

The Challenge of Replacing ICDs

Cardiac devices such as pacemakers and ICDs can become infected or stop working properly, which means they need to be modified, removed or replaced. In many cases, it’s the wires coming from the devices (also known as leads) that need to be removed or replaced. Yet, this work is highly technical – particularly for those patients whose devices have been in place for many years.

Lead Management Clinic

As part of the collaboration between WakeMed and Duke Health, a lead management clinic was established as the first of its kind in the region in February 2020. Bringing together Dr. Sean Pokorney, Duke Health cardiologist/electrophysiologist and WakeMed cardiovascular surgeon Dr. Judson Williams, the clinic has served dozens of patients with complex needs related to their implantable devices.

“Over time, scar tissue forms around these devices and their wires. Once the devices and their leads have been in place for a while, you can’t just slide them out – they’ve virtually become part of the body,” explains Dr. Pokorney.

“This makes modifying or replacing the devices an extremely precise process, and very few health centers have the expertise to remove leads that are infected or are no longer functioning properly. With this new clinic, we have the expertise and the highly-specialized tools that allow us to get faulty wires out and replaced without damaging the heart or surrounding blood vessels.”

A Multidiciplinary Team Delivering the Most Comprehensive Care

The benefit of having the dual expertise of a cardiovascular surgeon and an electrophysiologist means patients with implantable devices get a more comprehensive look at their care – which allows for more proactive device management over the years resulting in a reduced risk of infection and complications. Under Dr. Pokorney and Dr. Williams’ guidance, WakeMed has already become one of the top 100 centers for laser lead extraction by volume in the US.

“A multidisciplinary lead management clinic is a great example of Heart Care Plus+ driving innovative collaborative opportunities. This new offering is another indication of our collective commitment to both innovation and to patient-centered care at all times,” comments Dr. Williams.

Enjoy other heart and vascular stories of interest in our latest edition of Heart to Heart magazine.

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