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A European perspective on lead extraction: Part I

Published:September 21, 2007DOI:https://doi.org/10.1016/j.hrthm.2007.09.016
      The need for lead extraction has increased exponentially in the last decade due to greatly increased “total lead exposure time.” The increased total lead exposure time is the result of new indications for device treatment, device therapy involving more leads per patient, and longer average patient life. Improved general lead reliability noted over recent years may have decreased slightly the need for extraction; however, this effect is more than countered by recent advisories, recalls, and increased complication rates, probably related to many new centers offering device treatment. Total lead exposure time still is rising, especially in the United States, mainly due to increasing rates of implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy (CRT) lead implantation. The implantation rates for all types of devices are lower in Europe than in the United States; thus, the need for extraction can be expected to be higher in the United States than in Europe.

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