title: Considerations for cardiac device lead extraction.
abstract: Extraction of cardiovascular implantable electronic device leads is the removal of a lead that has been implanted for >1 year or that requires more than a standard stylet. The number of these procedures has greatly increased over the past few decades owing to the growing demand for primary and secondary implantations in ageing populations, and an accompanying rise in revisions for complications, infections, and lead advisory safety alerts. In this Review, we present the most common indications and techniques used for extraction. Particular consideration is given to the extraction of leads with large vegetations, recalled leads, stented leads, and those placed in the coronary sinus. We also summarize the most relevant and contemporary data on safety, efficacy, and outcomes of lead extraction.
authors.affiliation: Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Main Campus, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.
authors.forename: Oussama
authors.initials: O
authors.lastname: Wazni
authors.affiliation: Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Main Campus, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.
authors.forename: Bruce L
authors.initials: BL
authors.lastname: Wilkoff
mesh_terms: D017147:Defibrillators, Implantable / Q000009:adverse effects*; D020878:Device Removal / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D057052:Medical Device Recalls; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
references.citation: Acta Biomater. 2014 May;10(5):2200-8
references.pmid: 24434537
references.citation: Europace. 2008 May;10(5):556-7
references.pmid: 18227352
references.citation: Circulation. 2010 Jan 26;121(3):458-77
references.pmid: 20048212
references.citation: Europace. 2014 Nov;16(11):1674-8
references.pmid: 25344962
references.citation: Europace. 2014 Sep;16(9):1356-62
references.pmid: 24696221
references.citation: Pacing Clin Electrophysiol. 2005 Jul;28(7):661-6
references.pmid: 16008801
references.citation: Europace. 2016 Feb;18(2):246-52
references.pmid: 25767086
references.citation: J Am Coll Cardiol. 2011 Aug 30;58(10):1001-6
references.pmid: 21867833
references.citation: Heart Rhythm. 2009 Jan;6(1):65-8
references.pmid: 19121802
references.citation: Heart Rhythm. 2011 Nov;8(11):1678-85
references.pmid: 21699855
references.citation: Pacing Clin Electrophysiol. 2005 Aug;28(8):795-800
references.pmid: 16105007
references.citation: Europace. 2014 Oct;16(10 ):1490-5
references.pmid: 25087154
references.citation: J Am Coll Cardiol. 2006 Aug 1;48(3):590-1
references.pmid: 16875991
references.citation: Curr Treat Options Cardiovasc Med. 2012 Oct;14(5):565-70
references.pmid: 22886638
references.citation: J Am Coll Cardiol. 2007 May 8;49(18):1851-9
references.pmid: 17481444
references.citation: Heart Rhythm. 2009 Jul;6(7):1085-104
references.pmid: 19560098
references.citation: Heart Rhythm. 2012 May;9(5):723-7
references.pmid: 22182497
references.citation: Circulation. 1998 Oct 13;98(15):1517-24
references.pmid: 9769305
references.citation: J Cardiovasc Med (Hagerstown). 2014 Jul 21;:null
references.pmid: 25050526
references.citation: Mayo Clin Proc. 2008 Jan;83(1):46-53
references.pmid: 18174000
references.citation: Heart Rhythm. 2007 Jul;4(7):892-6
references.pmid: 17599673
references.citation: N Engl J Med. 2012 Mar 8;366(10 ):873-5
references.pmid: 22332951
references.citation: Heart Rhythm. 2014 Dec;11(12):2196-201
references.pmid: 25111324
references.citation: Rev Bras Cir Cardiovasc. 2009 Oct-Dec;24(4):570-3
references.pmid: 20305932
references.citation: Heart Rhythm. 2012 May;9(5):750-1
references.pmid: 22248757
references.citation: Heart. 2004 Aug;90(8):882-6
references.pmid: 15253959
references.citation: Heart Rhythm. 2008 Jun;5(6):775-9
references.pmid: 18534361
references.citation: Pacing Clin Electrophysiol. 2003 Oct;26(10):1944-50
references.pmid: 14516333
references.citation: Expert Rev Anti Infect Ther. 2010 Jul;8(7):831-9
references.pmid: 20586567
references.citation: Heart Rhythm. 2010 Sep;7(9):1340-5
references.pmid: 20647056
references.citation: Heart Rhythm. 2008 Dec;5(12):1675-81
references.pmid: 19084804
references.citation: Pacing Clin Electrophysiol. 1999 Sep;22(9):1348-57
references.pmid: 10527016
references.citation: Eur Heart J. 2008 Dec;29(23):2886-93
references.pmid: 18948356
references.citation: J Interv Card Electrophysiol. 2013 Jan;36(1):81-6; discussion 86
references.pmid: 22869386
references.citation: J Am Coll Cardiol. 2013 Mar 5;61(9):987-9
references.pmid: 23449433
references.citation: Pacing Clin Electrophysiol. 2001 Dec;24(12):1721-4
references.pmid: 11817804
references.citation: Heart Rhythm. 2009 Apr;6(4):474-7
references.pmid: 19324305
references.citation: J Interv Card Electrophysiol. 2000 Oct;4(3):523-8
references.pmid: 11046191
references.citation: Heart Rhythm. 2010 Aug;7(8):e3-4
references.pmid: 20621617
references.citation: J Am Coll Cardiol. 2010 Aug 17;56(8):646-50
references.pmid: 20598467
references.citation: Europace. 2014 May;16(5):625
references.pmid: 24465007
references.citation: Heart Rhythm. 2014 Sep;11(9):1613-8
references.pmid: 24854215
references.citation: J Card Surg. 2013 May;28(3):321-4
references.pmid: 23445461
references.citation: J Cardiovasc Electrophysiol. 2014 Jan;25(1):36-42
references.pmid: 24028661
references.citation: J Interv Card Electrophysiol. 2008 Oct;23(1):59-72
references.pmid: 18392929
references.citation: Heart Rhythm. 2009 May;6(5):611-2
references.pmid: 19389647
references.citation: Heart Rhythm. 2008 Oct;5(10):1380-1
references.pmid: 18929322
references.citation: Heart Rhythm. 2010 Jul;7(7):890-7
references.pmid: 20420939
references.citation: J Interv Card Electrophysiol. 2008 Nov;23 (2):135-7
references.pmid: 18516667
references.citation: Europace. 2007 Jan;9(1):69-73
references.pmid: 17224429
references.citation: Heart Rhythm. 2008 May;5(5):639-42
references.pmid: 18452862
references.citation: Circ Arrhythm Electrophysiol. 2010 Aug;3(4):413-24; discussion 424
references.pmid: 20716723
references.citation: J Am Coll Cardiol. 2010 Feb 9;55(6):579-86
references.pmid: 20152562
references.citation: Heart Rhythm. 2015 Mar;12(3):580-7
references.pmid: 25499627
references.citation: Heart Rhythm. 2012 May;9(5):742-9
references.pmid: 22209723
references.citation: Pacing Clin Electrophysiol. 2012 Jun;35(6):641-7
references.pmid: 22432739
references.citation: Heart Rhythm. 2015 Jun;12(6):1216-20
references.pmid: 25998138
references.citation: Heart Rhythm. 2012 Apr;9(4):494-8
references.pmid: 22056722
references.citation: J Thorac Cardiovasc Surg. 1987 Nov;94(5):770-2
references.pmid: 3669704
references.citation: Pacing Clin Electrophysiol. 2012 Feb;35(2):215-22
references.pmid: 22132903
references.citation: J Interv Card Electrophysiol. 2000 Oct;4(3):493-9
references.pmid: 11046188
references.citation: Europace. 2010 Sep;12(9):1275-81
references.pmid: 20621894
references.citation: Minerva Cardioangiol. 2015 Apr;63(2):91-8
references.pmid: 24941962
references.citation: Heart Rhythm. 2013 Oct;10(10):1444-50
references.pmid: 23816440
references.citation: Pacing Clin Electrophysiol. 2000 Apr;23(4 Pt 1):421-2
references.pmid: 10793427
references.citation: Heart Rhythm. 2015 Jun;12(6):1233-40
references.pmid: 25998139
references.citation: Pacing Clin Electrophysiol. 2003 Jan;26(1 Pt 2):524-6
references.pmid: 12687883
references.citation: Pacing Clin Electrophysiol. 2006 Mar;29(3):231-6
references.pmid: 16606389
references.citation: Pacing Clin Electrophysiol. 1994 Nov;17(11 Pt 2):2016-20
references.pmid: 7845810
references.citation: Heart. 2000 Jun;83(6):E12
references.pmid: 10814646
references.citation: Heart Rhythm. 2008 Oct;5(10):1375-9
references.pmid: 18783996
references.citation: Europace. 2009 May;11(5):546-7
references.pmid: 19359335
references.citation: Heart Rhythm. 2009 Sep;6(9):1397-401
references.pmid: 19716099
references.citation: Pacing Clin Electrophysiol. 2005 Mar;28(3):205-11
references.pmid: 15733180
references.citation: Europace. 2008 Mar;10(3):351-7
references.pmid: 18245771
references.citation: Pacing Clin Electrophysiol. 2002 May;25(5):804-8
references.pmid: 12049372
references.citation: Heart Rhythm. 2009 May;6(5):605-10
references.pmid: 19285920
references.citation: Circulation. 2007 May 15;115(19):2474-80
references.pmid: 17470696
references.citation: Kardiol Pol. 2010 Aug;68(8):884-90
references.pmid: 20730717
references.citation: Am Heart J. 2004 Apr;147(4):582-6
references.pmid: 15077071
references.citation: Am Heart J. 1972 Apr;83(4):469-74
references.pmid: 5041834
references.citation: Heart Rhythm. 2014 Mar;11(3):419-25
references.pmid: 24315967
references.citation: Heart Rhythm. 2015 Dec;12(12):2381-6
references.pmid: 26190318
references.citation: Circulation. 2007 Sep 18;116(12):1349-55
references.pmid: 17724263
references.citation: Pacing Clin Electrophysiol. 2010 Nov;33(11):1376-81
references.pmid: 20735715
references.citation: Heart Rhythm. 2008 Sep;5(9):1359-63
references.pmid: 18774117
references.citation: Pacing Clin Electrophysiol. 2011 Jul;34(7):e64-5
references.pmid: 20883510
references.citation: Circulation. 2010 Oct 19;122(16):1553-61
references.pmid: 20921437
references.citation: Int J Cardiol. 2013 Jul 15;167(1):254-7
references.pmid: 22236515
references.citation: Pacing Clin Electrophysiol. 2000 Apr;23 (4 Pt 1):423-6
references.pmid: 10793428
references.citation: Heart Rhythm. 2006 Apr;3(4):470-3
references.pmid: 16567298
references.citation: Heart Rhythm. 2015 Jun;12(6):1177-82
references.pmid: 25661776
references.citation: Heart Rhythm. 2009 Feb;6(2):204-9
references.pmid: 19103512
references.citation: Circ Arrhythm Electrophysiol. 2012 Apr;5(2):252-7
references.pmid: 22362891
references.citation: Heart Rhythm. 2010 Aug;7(8):1043-7
references.pmid: 20470904