Percutaneous lead extraction is considered a safe procedure with broadening indications, though further prospective evaluation against conservative approaches is still needed.
What are the current indications and long-term strategies for percutaneous lead extraction in patients with pacemaker and cardioverter-defibrillator systems?
Percutaneous lead extraction indications have expanded beyond infections, but prospective studies comparing it to conservative management are needed to optimize long-term patient strategies.
Based on the published results primarily from cohort studies, percutaneous lead extraction is now considered a safe procedure and indications for its use have broadened from device-related infections to less strict indications, such as recurrent isolated bacteremia, asymptomatic upper vein occlusion and malfunctioning/redundant leads. Almost 50% of electrophysiologists consider lead extraction in these latter situations. To broaden its implementation, further prospective evaluation against conservative approaches is still needed. Rather than only aiming at short-term results, this technique should be integrated into wide-ranging tailored long-term strategies to manage all of the different issues of implanted patients.
Diemberger et al. (Tue,) conducted a review in Pacemaker and cardioverter-defibrillator systems requiring lead extraction. Percutaneous lead extraction vs. Conservative approaches was evaluated. Percutaneous lead extraction is considered a safe procedure with broadening indications, though further prospective evaluation against conservative approaches is still needed.