Cardiac Implantable Electronic Device Lead Extractions

Abstract

Cardiac implantable electronic devices (CIEDs) are used for an increasing range of indications. With a broader range of indications, CIEDs are being implanted in increasing numbers. They are being used in older patients as well as patients with more comorbidities. As expected with these trends, the need for device extraction for a variety of reasons has steadily grown as well. These leads can often be removed via simple traction, but other techniques have been developed for circumstances where removal is more complex. To perform this procedure safely, a team-based approach is required, as is the ability to anticipate consequences of complications for each of the different methods of removal. A gold standard method has not been identified for transvenous lead extraction, but rather one has a toolbox of methods at their disposal. In this chapter, indications for lead removal, extraction techniques and devices, as well as potential complications are reviewed.