Intravascular pacemaker and defibrillator lead extraction: A state-of-the-art review

As the number of implantable arrhythmia devices rapidly increases around the world, so too does the need for a safe and effective method for extracting both pacemaker and defibrillator leads. Lead extraction is an important and necessary component of treatment for many common device- and lead-related complications. However, lead extraction is a procedure that can provoke much anxiety in even the most experienced operators given the potentially serious complications, which include lead breakage, venous or myocardial tear, tamponade, and even death. Fortunately, technology has advanced significantly, providing clinicians with newer and safer techniques to remove both acute and chronic leads. In this article, we review the important techniques used in modern-day lead extraction and the indications, success rates, complications, and new horizons for this procedure.