Establishing a Cardiac Implantable Electronic Device Lead Extraction Program in a Resource-Limited Setting
Giselle G Gervacio1,2, Jhobeleen D De Leon1,2, Michael Joseph C Agbayani1,2
1Section of Electrophysiology and Pacing, Division of Cardiovascular Medicine, Department of Medicine University of the Philippines-Philippine General Hospital Manila Philippines.
Journal of Arrhythmia
|September 17, 2025
Summary
A new lead extraction program was established at UP-PGH to address rising cardiac implantable electronic device infections and malfunctions. The program successfully removed infected pacemaker and ICD leads without complications, proving feasibility in developing countries.
Area of Science:
- Cardiology
- Medical Device Technology
- Public Health
Background:
- Increasing cardiac implantable electronic device (CIED) implantations in Asia correlate with a rise in CIED-related infections and lead malfunctions.
- Establishing a dedicated lead extraction program is crucial for managing these complications effectively.
Purpose of the Study:
- To describe the establishment and initial implementation of the University of the Philippines-Philippine General Hospital (UP-PGH) Lead Extraction Program.
- To assess the feasibility and safety of a lead extraction program in a developing country context.
Main Methods:
- A descriptive analysis of data collected on preoperative, intraoperative, and postoperative management.
- Detailed documentation of resources, personnel, and established workflows.
- Implementation of a structured program including personnel training and equipment procurement.
Main Results:
- The UP-PGH Lead Extraction Program successfully launched, completing four procedures (eight leads) within the first year.
- All lead extractions were performed without complications by an electrophysiologist-led team.
- Key components like personnel training, equipment, hospital support, and workflow development were successfully implemented.
Conclusions:
- The successful launch of the UP-PGH Lead Extraction Program demonstrates the feasibility of establishing such programs in developing countries.
- Well-defined workflows and adequate resource planning are critical for the successful implementation of lead extraction services.
