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Difficulty and Complications of Lead Extraction-Is ICD Lead Design Important?
Andrzej Kutarski1, Wojciech Jacheć1, Paweł Stefańczyk2
12nd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
Pacing and Clinical Electrophysiology : PACE
|February 3, 2026
Summary
Transvenous lead extraction (TLE) of implantable cardioverter-defibrillator (ICD) leads is safer and less complex than pacemaker (PM) lead extraction, with fewer major complications. Lead design did not significantly impact TLE safety, but some manufacturers showed lower success rates.
Area of Science:
- Cardiology
- Medical Devices
- Surgical Procedures
Background:
- Transvenous removal of implantable cardioverter-defibrillator (ICD) leads is perceived as challenging and high-risk.
- Understanding the influence of ICD lead design on transvenous lead extraction (TLE) safety and effectiveness is crucial.
Purpose of the Study:
- To investigate the impact of ICD lead design on the safety and effectiveness of transvenous lead extraction (TLE).
- To compare TLE outcomes between ICD leads and pacemaker (PM) leads.
Main Methods:
- Retrospective analysis of 3929 TLE procedures, including 1068 involving ICD lead extraction.
- Comparison of major complication rates, procedural complexity, and success rates between ICD and PM lead extractions.
Main Results:
- ICD leads were significantly younger at extraction (median 61 months vs. 97 months for PM leads).
- Major complication rates were lower for ICD lead extraction (0.75%) compared to PM lead extraction (2.25%).
- Complete procedural success was lower for PM lead extraction compared to ICD lead extraction.
Conclusions:
- ICD lead extraction is generally less complex and safer than PM lead extraction, potentially due to shorter implant duration.
- No significant differences in TLE complexity or complications were observed based on ICD lead manufacturer.
- Abbott and Biotronik ICD leads were associated with lower rates of complete procedural success compared to Medtronic leads.
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