Cardiac lead management: the future of transvenous lead extraction approaches and technologies

The implantation rate of cardiac implantable electronical devices (CIED) has consistently increased in the last 20 years, so as related complication rates. According, devices infections and malfunctions required the development of appropriate strategies, including lead removal. Transvenous lead extraction (TLE) is the gold standard for lead removal. The increasing rate of CIED implantations and of CIED related complications highlight the importance of TLE. TLE scenario is constantly evolving. TLE is a key procedure in lead management strategies. Optimizing lead related technology and improving TLE practice across the world is the cornerstone to improve safety and efficacy. We review the status of the art of TLE, focusing on potential future implications and improvements in terms of skillness and technologies. The increased number of extractions will increase the necessity of safe and effective TLE. The use of adequate tools, techniques and approaches, and an appropriate training are the cornerstone for safer procedures achievement. New technologies, techniques and an appropriate training is warranted across the world.