Multidisciplinary Approach to Transvenous Lead Extraction: A Single Center’s Experience

ObjectiveTo evaluate the success and complication rates of a single center’s multidisciplinary approach to transvenous lead extraction.SettingOne university hospital.ParticipantsOne hundred ninety-five patients scheduled for transvenous lead extraction.InterventionsA multidisciplinary approach to transvenous lead extraction involving cardiac surgery, electrophysiology, perfusion, and cardiac anesthesiology.Measurements and Main ResultsA case series of 351 lead extractions performed in 195 patients over a 42-month period. Indications, success rates, and complication rates were tracked and retrospectively evaluated and reported. Indications for lead extraction included 53.3% because of lead malfunction, 36.9% because of infection, with the remaining 9.7% from other categories such as venous stenosis. The lead extraction rate was 99.7%, with complete removal in 97.7%. The overall major complication rate was 3.08%. After an initial 1-year period of performing lead extractions, the overall major complication rate reduced to 1.23%.ConclusionsTransvenous lead extraction generally is a safe procedure, but not without complications. A multidisciplinary approach involving cardiac surgery, electrophysiology, and cardiac anesthesiology allows for successful management and the ability to rapidly manage major complications.