A European perspective on lead extraction: Part I

Published:September 21, 2007DOI:
      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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        • Love C.J.
        • Wilkoff B.L.
        • Byrd C.L.
        • et al.
        Recommendations for extraction of chronically implanted transvenous pacing and defibrillator leads.
        Pacing Clin Electrophysiol. 2000; 23: 544-551
        • Klug D.
        • Wallet F Lacroix D.
        • et al.
        Local symptoms at the site of pacemaker implantation indicate latent systemic infection.
        Heart. 2004; 8: 882-886
        • Suga C.
        • Hayes D.L.
        • Hyberger L.K.
        • et al.
        Is there an adverse outcome from abandoned pacing leads?.
        J Interv Card Electrophysiol. 2000; 3: 493-499
        • Sohail M.R.
        • Uslan D.Z.
        • Khan A.H.
        • et al.
        Risk factor analysis of permanent pacemaker infection.
        Clin Infect Dis. 2007; 45: 166-173
        • Field M.E.
        • Jones S.O.
        • Epstein L.M.
        Hands on: how to select patients for lead extraction.
        Heart Rhythm. 2007; 7: 978-985
        • Bongiorni M.G.
        • Giannola G.
        • Arena G.
        • et al.
        Pacing and implantable cardioverter-defibrillator transvenous lead extraction.
        Ital Heart J. 2005; 3: 261-266
        • Neuzil P.
        • Taborsky M.
        • Rezek Z.
        • et al.
        Pacemaker and ICD lead extraction with electrosurgical dissection sheaths and standard transvenous extraction systems: results of a randomized trial.
        Europace. 2007; 2: 98-104
        • Uslan D.Z.
        • Sohail M.R.
        • St. Sauver J.L.
        • et al.
        Permanent pacemaker and implantable cardioverter defibrillator infection: a population based study.
        Arch Intern Med. 2007; 167: 669-675
        • Verma A.
        • Wilkoff B.L.
        Intravascular pacemaker and defibrillator lead extraction: a state-of-the-art review.
        Heart Rhythm. 2004; 1: 739-745
        • Byrd C.L.
        • Wilkoff B.L.
        • Love C.J.
        • et al.
        Intravascular extraction of problematic or infected permanent pacemaker leads: 1994–1996. U.S. Extraction Database, MED Institute.
        Pacing Clin Electrophysiol. 1999; 9: 1348-1357
        • Esposito M.
        • Kennergren C.
        • Holmström N.
        • et al.
        Morphologic and immunohistochemical observations of tissues surrounding retrieved transvenous pacemaker leads.
        J Biomed Mater Res. 2002; 63: 548-558
        • Kennergren C.
        • Bucknall C.A.
        • Butter C.
        • et al.
        Laser assisted lead extraction: the European experience.
        Europace. 2007; 9: 651-656
        • Hirschl D.A.
        • Jain V.R.
        • Spindola-Franco H.
        • et al.
        Prevalence and characterization of asymptomatic pacemaker and ICD lead perforation on CT.
        Pacing Clin Electrophysiol. 2007; 30: 28-32