Key result
Transvenous lead extraction carries low procedural mortality but only ~50% 10-year survival.
Why the study?
With steadily increasing CIED implantations and high long-term mortality following transvenous lead extraction, a review of current indications, procedural considerations, and management based upon latest guidelines was needed.
This review summarizes the indications, procedural considerations, and management of patients undergoing transvenous lead extraction based on current guidelines.
Requires attention to long-term prognosis after extraction; leaves open targeted interventions to improve survival.
Cardiac implantable electronic device (CIED) implantation has steadily increased in the United States owing to increased life expectancy, better access to health care, and the adoption of updated guidelines. Transvenous lead extraction (TLE) is an invasive technique for the removal of CIED devices, and the most common indications include device infections, lead failures, and venous occlusion. Although in-hospital and procedure-related deaths for patients undergoing TLE are low, the long-term mortality remains high with 10-year survival reported close to 50% after TLE. This is likely demonstrative of the increased burden of comorbidities with aging. There are guidelines provided by various professional societies, including the Heart Rhythm Society, regarding indications for lead extraction and management of these patients. In this paper, we will review the indications for CIED extraction, procedural considerations, and management of these patients based upon the latest guidelines.
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Khurana et al. (2023) conducted a review in Cardiac implantable electronic device (CIED) extraction. Transvenous lead extraction (TLE) was evaluated. Transvenous lead extraction is associated with low procedure-related mortality but high long-term mortality, with 10-year survival reported close to 50%.
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