Percutaneous Extraction of a Long-Standing, Inadvertently Malpositioned Left-Atrial Lead during CIED Infection

There is limited evidence in the literature regarding the safety and feasibility of transvenous extraction for leads malpositioned in the left heart for an extended period. This report presents a challenging case of a 44-year-old male with a pacemaker pocket infection and bacteremia, in whom a previously unrecognized atrial lead malposition into the left atrium-present for 17 years-was identified and successfully extracted. This report suggests that percutaneous extraction of a long-standing, malpositioned lead in the left heart is both mandatory and feasible in the setting of cardiac implantable electronic device infection.