Comparative durability of pacemaker leads in transvenous lead extraction: An evaluation through bench testing

Area of Science:

• Cardiovascular medicine
• Biomedical engineering
• Medical device technology

Background:

• Transvenous lead extraction (TLE) offers a less invasive approach than surgical removal for pacemaker and defibrillator leads.
• Lead integrity can be compromised during TLE, posing risks to patient safety and procedural success.

Purpose of the Study:

• To evaluate and compare the tensile strength and stress behavior of various transvenous leads during TLE.
• To assess how different extraction techniques influence lead durability and failure modes.

Main Methods:

• Tensile testing was performed on multiple lead models (Tendril STS, INGEVITY, INGEVITY+, Solia S, CapSure Fix) using a testing machine.
• Leads were tested with terminal removed, terminal retained, and snare extraction configurations.
• Durability was quantified by measuring force, elongation, and disruption force.

Main Results:

• Significant variability in lead tensile strength was observed, dependent on lead type and extraction technique.
• INGEVITY and INGEVITY+ leads demonstrated enhanced durability with snare use, while Tendril STS showed lower durability when the terminal was removed.
• Solia S and CapSure Fix leads exhibited consistent high durability regardless of terminal status.

Conclusions:

• Lead behavior during TLE varies considerably among manufacturers and extraction methods.
• Techniques like terminal retention and snare usage can enhance lead durability, particularly for leads with longer implantation times or anticipated high extraction forces.