Intravascular extraction of chronically implanted permanent transvenous pacing leads
Medical Services Advisory Committee
Record ID 31999009754
English
Authors' objectives:
This report summarises the assessment of current evidence for intravascular extraction of chronically implanted permanent transvenous pacing leads using the surgical tools described and countertraction.
Authors' recommendations:
MSAC noted that the procedure is being performed by a small number of cardiologists and that it can be claimed under the Medicare Benefits Schedule (MBS). However, additional remuneration has been sought.
MSAC also noted that the available evidence indicates the extraction of chronically implanted permanent transvenous pacemaker leads using surgical tools and countertraction is an effective procedure which offers a minimally invasive and generally safe alternative to open heart surgery when performed by skilled operators with specialised training and experience. It is a much longer, more difficult and skilled procedure than extraction of leads not entrapped by fibrous tissue, which is performed by simple traction without the use of surgical tools. Currently, both procedures are remunerated at the same rate.
MSAC therefore recommended that, on the strength of the evidence pertaining to the extraction of chronically implanted permanent transvenous pacemaker leads:
additional public funding should be supported for the extraction of chronically implanted permanent transvenous pacemaker leads which have been implanted more than three months and require use of surgical tools and countertraction for their removal; and
the performance of the procedure should be restricted to cardiologists and cardiothoracic surgeons who have undergone specialist training in the procedure and are willing to participate in an audit program administered by the Cardiac Society of Australia and New Zealand, in order to achieve accreditation as a specialist provider of the procedure.
Authors' methods:
Systematic review
Details
Project Status:
Completed
URL for project:
http://www.health.gov.au/haf/msac
Year Published:
1999
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Australia
MeSH Terms
- Cardiac Pacing, Artificial
- Cardiac Surgical Procedures
- Pacemaker, Artificial
- Minimally Invasive Surgical Procedures
- Veins
Contact
Organisation Name:
Medical Services Advisory Committee
Contact Address:
MSAC (MDP 107), GPO Box 9848, Canberra, ACT 2601, Australia. Tel: +61 2 6289 6811; Fax: +61 2 6289 8799.
Contact Name:
msac.secretariat@health.gov.au
Contact Email:
msac.secretariat@health.gov.au
Copyright:
Medical Services Advisory Committee
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.