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Systematic Review on S-ICD Lead Extraction.

Riccardo Vio1, Enrico Forlin1,2, Viktor Čulić3,4

  • 1Department of Cardiothoracic, Vascular Medicine and Intensive Care, Dell'Angelo Hospital, 30174 Mestre-Venice, Italy.

Journal of Clinical Medicine
|June 10, 2023
PubMed
Summary

Subcutaneous implantable cardioverter defibrillator (S-ICD) lead extraction is primarily for non-infective reasons. This review synthesizes data on S-ICD lead extraction techniques, indications, and outcomes.

Keywords:
ICDS-ICDexplantationextractioninfectionsubcutaneous implantable cardioverter defibrillator

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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.