Related Experiment Video
Updated: Jul 26, 2026
Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Single center experience with femoral extraction of permanent endocardial pacing leads
1Lille University Hospital, France.
Insights
This study evaluated the safety and efficacy of cardiac lead extraction in 128 patients. The procedure demonstrated a high success rate (95%) with minimal complications, making it a viable option for lead removal.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Procedures
Background:
- Cardiac leads, essential for pacemakers and defibrillators, can necessitate removal due to complications.
- Indications for lead extraction include infection, device malfunction, and lead integrity issues.
Purpose of the Study:
- To assess the outcomes and safety of transvenous lead extraction.
- To identify common reasons for lead extraction and evaluate procedural success rates.
Main Methods:
- A retrospective analysis of 128 cardiac lead extractions performed between March 1995 and June 1997.
- Leads were extracted using snare techniques, primarily via femoral venous access.
- Extraction success rates and complication incidence were recorded.
Main Results:
- Complete extraction was achieved in 95% of cases (122 out of 128 leads).
- The primary indications for extraction were lead endocarditis (32%) and pulse generator pocket infection (22%).
- Four minor complications occurred, with no procedure-related deaths or serious adverse events.
Conclusions:
- Transvenous lead extraction is a safe and effective procedure for managing complications associated with implanted cardiac leads.
- High success rates and a low complication profile support the continued use of lead extraction techniques.
Abstract:
Between March 1995 and June 1997, 128 leads were extracted from the hearts of 28 women and 50 men, 69 +/- 15 years of age (mean +/- SD, range 22-92 years). The indications for the procedure were: Accufix leads in 18 patients (14%), dysfunction or incompatibility with ICD in 16 (12%), endocarditis on the lead in 41 (32%), pulse generator pocket infection in 28 (22%), and pulse generator and/or lead erosion in 25 patients (19%). The extraction was performed with a snare (lasso), via a femoral vein as a first approach in 116 leads, and as an alternate approach, after extraction from the original site of implantation had failed, in 12 leads. The leads had been implanted for 62 +/- 48 months (range 1-205 months). A Cook sheath was used in 7, and a femoral approach traction in 20 instances. Of the 128 leads, 122 (95%) were completely extracted, and 2 (2%) were partially extracted (the distal electrode remaining attached to the myocardium), and 4 (3%) could not be removed. Four complications occurred: 2 tears of the tricuspid valve without clinical consequences, one separation of the lead's distal electrode which migrated into the hypogastric vein, and one hemorrhage at the femoral puncture site. There was no death or serious complication caused by lead extraction in this series.
Related Concept Videos
01:21Cardiac Catheterization II: Right Heart Catheterization
01:24Cardiac Catheterization III: Left Heart Catheterization
01:26Cardiac Catheterization IV: Nursing Management