Khurana Sumit, Das Subrat, Frishman William H, Aronow Wilbert S, Frenkel Daniel
From the Department of Internal medicine, MedStar Union Memorial hospital, Baltimore, MD.
Department of Cardiology, New York Medical College, Westchester Medical Center, Valhalla, NY.
Cardiol Rev. 2025;33(3):212-218. doi: 10.1097/CRD.0000000000000610. Epub 2023 Sep 20.
Cardiac implantable electronic device (CIED) implantation has steadily increased in the United States owing to increased life expectancy, better access to health care, and the adoption of updated guidelines. Transvenous lead extraction (TLE) is an invasive technique for the removal of CIED devices, and the most common indications include device infections, lead failures, and venous occlusion. Although in-hospital and procedure-related deaths for patients undergoing TLE are low, the long-term mortality remains high with 10-year survival reported close to 50% after TLE. This is likely demonstrative of the increased burden of comorbidities with aging. There are guidelines provided by various professional societies, including the Heart Rhythm Society, regarding indications for lead extraction and management of these patients. In this paper, we will review the indications for CIED extraction, procedural considerations, and management of these patients based upon the latest guidelines.
