Transvenous lead extraction: predictors of procedure complexity

BACKGROUND AND AIMS: Over the past decades, high-volume lead extraction centres gained broad experience in advanced transvenous lead extractions (TLE). However, access to advanced TLE techniques is limited, thus it would be beneficial to predict which extractions can be performed safely and effectively by simple procedures. We aimed to report on predictors of procedure complexity in clinically successful TLEs. METHODS: Our retrospective study included 70 infectious TLEs, of which 65 were clinically successful. TLEs were defined as simple if only simple manual traction or a locking stylet was required, and complex if a rotational mechanical sheath or a femoral snare was used. RESULTS: 42 patients underwent a complex procedure and 23 patients underwent a simple procedure. Overall, 129 leads were extracted. Complex procedures were characterised by longer lead dwell time (mean: 10.7±6.5 years vs 3.2±2.1 years; p