Arrhythmias & electrophysiology
Comparison of non-laser and laser transvenous lead extraction: a systematic review and meta-analysis
Authors' conclusion
Non-laser TLE is associated with a better safety and efficacy profile when compared with laser methods. There is a greater risk of SVC injury associated with laser sheath extraction.
Study context
- Population
- Patients undergoing transvenous lead extraction (TLE), studies published 1991–202168 studies
- Comparison
- Non-laser vs laser transvenous lead extraction
- Outcome
- Safety and efficacy of TLE: procedural mortality, major complications, SVC injury, complete and clinical success (pooled rates, OR)
Pooled result
As reported in the abstract
Non-laser
- Procedural mortality
- 0%
- Major complications
- 0.7%
- Superior vena cava (SVC) injury
- 0%
- Complete success
- 96.5%
Laser
- Procedural mortality
- 0.1%
- Major complications
- 1.7%
- SVC injury
- 0.5%
- Complete success
- 93.8%
Procedural mortality
Non-laser0%
Laser0.1%
Major complications
Non-laser0.7%
Laser1.7%
Superior vena cava (SVC) injury
Non-laser0%
Laser0.5%
Complete success
Non-laser96.5%
Laser93.8%
Non-laser vs LaserOdds ratio (CI)P value
Clinical success
2.16(1.77–2.63)
P < 0.01Complete success
1.87(1.69–2.08)
P < 0.01- Lower procedural mortality risk with non-laser
- OR 1.6 (CI 1.02–2.5); P < 0.05
Further pooled results
| Outcome | Laser | P value |
|---|---|---|
| Complete success and SVC injury, rotational tool vs laser (subgroup) | ||
| Complete success (pooled rate) | 95% | P < 0.01 |
| SVC injury (pooled rate) | 0.7% | P < 0.01 |
- Complete success and SVC injury, rotational tool vs laser (subgroup): Rotational tool Complete success (pooled rate) 97.4% · SVC injury (pooled rate) 0%
Original publication
Comparison of non-laser and laser transvenous lead extraction: a systematic review and meta-analysis. Europace. Published 26 October 2023. doi:10.
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