The major risks of percutaneous lead extraction include cardiac perforation (1%–4%), emergency cardiac surgery (1%–2%), and death (0.4%–0.8%). However, risk to an individual varies in accordance with a number of factors (Table 1), and informed consent must be tailored to the specific patient. Indicators of very high risk (Table 2) define relative contraindications to the procedure; patients without other options should be referred to experienced centers capable of managing these special cases. Surgical backup should be secured prior to every extraction.
