Laurence M. Epstein, MD, performed lead extractions and trained physicians at a Chinese hospital.

Laurence M. Epstein, MD, performed lead extractions and trained physicians at a Chinese hospital.

BWH recently made the news in China when Laurence M. Epstein, MD, chief of Cardiac Arrhythmia, visited Peking University People’s Hospital in Beijing, China, to perform cardiac defibrillator lead extractions on patients in dire need. In a single day, Epstein performed five lead extractions, including the first laser-assisted lead extraction in China, and trained physicians from the Chinese hospital to perform the procedure for others.

“One of my goals is to help my colleagues all over the world raise the bar and offer the appropriate treatment for these patients,” said Epstein. “This was an opportunity to take care of these individuals who had an acute need but also serve the larger goal of helping physicians establish a program so that they can continue helping patients in need.”

In a video that aired on the news in China, Epstein can be seen treating a patient whose defibrillator had gotten infected and had eroded through the skin, adhering to the skin outside of his chest.

Epstein, who specializes in extracting pacemaker and defibrillator leads, is regarded as one of the world’s leading experts in this procedure. After an infection, removing the leads, or wires that run between the device and the heart, requires great care. Pulling directly on the leads can cause a tear in a blood vessel or the heart and/or break the lead off in the heart. Instead, Epstein inserts a sheath that has the fiber optics of a laser wrapped around it. He passes this over the lead and activates the laser at just the right moment to break up scar tissue around the lead, making its extraction much safer.

Epstein’s colleagues in China had reached out to invite him to come to perform the procedures locally, but patients also come from all over the world to be treated in Boston by BWH’s cardiovascular team. The team has recently treated patients from across the United States, Saudi Arabia, Sudan, India and elsewhere.