Step by Step through the Years-High vs. Low Energy Lead Extraction Using Advanced Extraction Techniques.

Area of Science:

• Cardiology
• Electrophysiology
• Medical Device Extraction

Background:

• Limited data exists on transvenous lead extraction (TLE) outcomes in patients with high-energy leads compared to those without.
• Evaluating TLE outcomes is crucial for managing patients with implanted cardiac devices.

Purpose of the Study:

• To compare the outcomes of TLE in patients with high-energy leads (ICD group) versus those without (non-ICD group).
• To assess procedural success and complication rates in a high-volume TLE center.

Main Methods:

• Analysis of consecutive patients undergoing TLE from 2001 to 2021 using a stepwise approach.
• Comparison of baseline characteristics, procedural details, and outcomes between the ICD and non-ICD groups.

Main Results:

• Higher utilization of advanced extraction tools in the ICD group (73.2% vs. 37.5%).
• No significant differences in successful lead removal (98.8% vs. 99.2%) or complication rates (4.7% vs. 3.1%) between groups.
• ICD patients were younger (median 67 vs. 74 years) and less often female (18.1% vs. 27.7%).

Conclusions:

• The stepwise approach in a high-volume center yields high procedural success and low complication rates for TLE.
• TLE in patients with high-energy leads is more complex but achieves similar outcomes to TLE in patients without high-energy leads.