Effective and safe mechanical transvenous lead extraction in a low-volume center

Background: Transvenous lead extraction (TLE) of cardiac implantable electronic devices was once deemed highly risky by high-volume centers. However, advancements in technology have significantly reduced the risk, making TLE a safer procedure in electrophysiology. Objective: The purpose of this study was to examine the efficacy and safety of mechanical TLEs in a low-volume center with a single operator. Methods: This study retrospectively accessed electronic medical records from the Tulane University School of Medicine system in New Orleans, Louisiana, and included patients who received mechanical TLE from 2016 to 2023. We analyzed the indications for TLE, patient characteristics, lead characteristics, success rate, and complications. Results: We included 149 consecutive mechanical TLEs with an average implant duration of 105 months. A total of 53.7% (80) of TLEs were indicated for infectious reasons, and 37.6% (56) were high-voltage leads. Clinical success and complete procedural success rates were both 94.6% with no procedure-related mortality or major complications. The periprocedural mortality rate was 1.25% (1). Minor complications included a left chest pocket hematoma, a left groin hematoma, and urinary retention. Conclusion: The efficacy and safety of mechanical TLEs performed in a low-volume center are comparable with those in high-volume centers.