Key result
Transvenous lead extraction achieves >90% clinical success across all age groups.
Why the study?
With increasing CIED use and associated complications, this study aimed to summarize success rates and common complications of transvenous lead extraction.
What are the success rates and complications of transvenous lead extraction in patients with cardiac implantable electronic devices?
Systematic Review
What are the success rates and complications of transvenous lead extraction in patients with cardiac implantable electronic devices?
Transvenous lead extraction is a highly successful and generally safe procedure for managing CIED complications across all age groups, though it carries risks of tricuspid regurgitation and vascular tears.
Supports transvenous lead extraction for CIED complications across ages; confirms >90% success in pooled Level 1 evidence.
An increase in cardiovascular implantable electronic devices (CIEDs) and undoubtedly the complications brought on by these devices coincide with an increase in cardiovascular disorders, particularly heart rhythm abnormalities. The safest procedure to extract these devices is transvenous lead extraction (TLE). Thus, this systematic review aimed to summarize the possibility of success rates and the common complications that could arise during the surgery. Full-text publications in PubMed, MEDLINE, PubMed Central (PMC), and ScienceDirect were used in this study, which was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seventeen studies were reviewed for this systematic review after being screened by title, abstract, full-text availability, and quality appraisal assessment. Heart and vascular tears, along with tricuspid regurgitation (TR), are common adverse events. Pulmonary embolism, hemothorax, hemopericardium, and ghost appearance in echo are less common consequences. In addition, the longer the dwelling time of the leads, the greater the chance of infection due to an increase in lead adhesions and fibrous tissue that has made the procedure unsafe as time passes. However, we concluded that TLE is a successful method across all age groups with an excellent probability of clinical and procedural success in a majority of studies.
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Salib et al. (2023) conducted a systematic review in Cardiac Implantable Electronic Devices (CIED) requiring transvenous lead extraction. Transvenous lead extraction (TLE) was evaluated on Clinical success rate. Transvenous lead extraction is a successful method across all age groups, demonstrating clinical success rates exceeding 90% in the majority of studies.
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