Arrhythmia device lead extraction: Factors that necessitate laser assistance

Lead Extraction in Pediatric and Congenital Heart Disease Patients

“…Although others 4,12 have identified defibrillator leads to be predictors of failed simple extraction, when we included defibrillator versus pacemaker lead type in our model, it did not reach statistical significance. The presence of a system infection has faired out as a predictor of simple extraction in certain adult patient series 5,12,13 ; however, in the present study, it did not reach statistical significance on multivariable analysis. It is important to note that system infection was rare (8%) in our series compared with being the predominant indication for lead extraction in most series on older adults.…”

“…In our center's experience, successful lead extraction was achieved in about one third of patients, using simple traction with a nonlocking stylet, an outcome similar to that reported in several large series on older adult patients with simple extraction success rates ranging from 16.4% to 31.2%. [1][2][3][4][5]7,12 Of the leads undergoing a complex extraction in our study, about three quarters required the use of an RF-powered sheath, which was successful in more than half, for a cumulative success rate of 94%. There are no reports on the use of RF-powered sheaths in pediatric or adult CHD patients.…”

“…1,[3][4][5]7,12,13 In the study by Mathur et al, 7 a lead in the atrial position was also found to be correlated with simple extraction by traction. Although others 4,12 have identified defibrillator leads to be predictors of failed simple extraction, when we included defibrillator versus pacemaker lead type in our model, it did not reach statistical significance. The presence of a system infection has faired out as a predictor of simple extraction in certain adult patient series 5,12,13 ; however, in the present study, it did not reach statistical significance on multivariable analysis.…”

“…Several large series have investigated the different lead extraction techniques and their safety and efficacy in adult patients without CHD. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] However, data on lead extraction in pediatric and CHD patients remain limited. [15][16][17][18] …”

Multicenter Experience With Extraction of the Sprint Fidelis Implantable Cardioverter-Defibrillator Lead

“…The minor complications seen in this cohort were not associated with the lead extraction itself; rather, they are risks associated with any cardiac rhythm device implant. As is the case with extraction of other leads (14,18,19), we found that lead implant duration, younger patient age, and the absence of infection were associated with a significant increase in the need for CTS assistance, thereby increasing the complexity of the extraction procedure.…”