Extraction of cardiac leads and electrodes will continue to be a statistical necessity as electrode implant numbers and durations increase. Improved implant success and expanded indications in heart failure patients for left ventricular (LV) pacing electrodes via the coronary sinus (CS) and its branches have resulted in unique interactions among the leads, venous system, and epicardial heart that are not typically seen with traditional endocardial right heart cardiac electrodes. LV lead placement, as well as the myocardium’s response to it, requires continual evaluation to better understand the limitations that may be encountered during extraction of LV leads, especially as the mean duration of implant reaches beyond 1 year.
