Systematic Review on S-ICD Lead Extraction.

Area of Science:

• Cardiology
• Medical Devices
• Electrophysiology

Background:

• Subcutaneous implantable cardioverter defibrillators (S-ICDs) are an alternative to transvenous ICDs (TV-ICDs).
• Increasing S-ICD use leads to more S-ICD-related complications requiring device removal.
• Subcutaneous implantable cardioverter defibrillator lead extraction (SLE) literature is limited.

Purpose of the Study:

• To systematically review existing literature on S-ICD lead extraction (SLE).
• To analyze indications, techniques, complications, and success rates of SLE.
• To identify gaps in current knowledge and suggest future directions for SLE.

Main Methods:

• Systematic literature search of Medline, Scopus, and Web of Science databases.
• Keywords included: subcutaneous, S-ICD, defibrillator, ICD, extraction, explantation.
• Included studies involved patients with S-ICDs who underwent SLE; 30 studies with 207 patients were analyzed.

Main Results:

• The majority of SLEs (59.90%) were for non-infective causes; infection accounted for 38.65%.
• Mean device dwelling time before extraction was 14 months.
• SLE techniques included manual traction or tools designed for transvenous lead extraction (TLE).

Conclusions:

• Subcutaneous implantable cardioverter defibrillator lead extraction is predominantly for non-infective indications.
• Current SLE techniques are varied, highlighting a need for standardization.
• Development of dedicated SLE tools and shared experiences are encouraged to refine approaches.