Arrhythmias & electrophysiology
Transvenous Lead Extraction Without Dedicated Surgical Back up in Low-Risk Patients
Authors' conclusion
This study suggests that, in selected "low-risk" patients, TLE can be performed safely in an experienced EP lab at centers with on-site cardiac surgery but without a dedicated surgical standby team, potentially reducing resource utilization in resource-limited healthcare environments.
Study context
- Population
- Patients who underwent low-risk transvenous lead extraction (TLE) (pacing or ICD lead with dwell time >= 1 and <= 5 years, or a lead < 1 year that required extraction tools) at Emory Healthcare between 2010–23, in an EP lab without dedicated surgical back-uppatients who met the criteria
- Participants
- 482 patients
- Outcome
- Lead age
Methodological detailssingle institution (Emory Healthcare)
- Single institution (Emory Healthcare)
Main finding
As reported in the abstract
Average lead age
2.8 ± 1.2 years
Observational data: associations, not effects.
Further findings
Number of targeted leads per patient
- Mean number of targeted leads per patient
- 1.6±0.7
Extraction tools required
- Cases requiring extraction tools
- 33.1%
Safety
Major complications
- Major complications
- 0.83% of patients (n=4)
- Pericardial effusions requiring pericardiocentesis
- 2
- Pneumothorax
- 1
- Death from cardiogenic shock in an end stage heart failure patient
- 1
- Patients with pericardial effusions and pneumothorax were part of a procedure that required lead revisions and the insertion of 1 or more new leads
Surgical rescue
- No patients required surgical rescue
Original publication
Transvenous Lead Extraction Without Dedicated Surgical Back up in Low-Risk Patients. Heart Rhythm. Published 22 October 2026. doi:10.
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