• Rabea Haddad, Edo Birati, Hiba Zayyad, Nizar Andria, Eyal Nachum, Erez Kachel, and Ibrahim Marai.
• Department of Cardiovascular Medicine, Tzafon Medical Center, Lower Galilee, Israel, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
• Isr Med Assoc J. 2024 May 1; 26 (5): 273277273-277.

BackgroundCardiac implantable electronic devices (CIEDs) are increasingly being used; thus, there is an increasing need for transvenous lead extraction (TLE).ObjectivesTo summarize our experience with TLE at single referral center in northern Israel.MethodsThe study included all patients who underwent TLE at our center between 2019 and 2022, regardless of the indication.ResultsThe cohort included 50 patients. The mean age was 69 ± 10.36 years; 78% were males. A total of 99 electrodes were targeted. The mean number of electrodes was 1.96 (range 1-4) per patient. The time between lead implantation and extraction ranged between 1.1 and 34 years with an average of 8.14 ± 5.71 years (median of 7.5 years). Complete lead removal was achieved in 98% of patients and in 98.99% of leads. The complete procedural success rate as well as the clinical procedural success rate was 96%. The procedural failure rate was 4% (1 patient died 2 days after the index procedure and 1 patient remained with large portion of lead). The indication for TLE was infection in 78% of the cohort group. Powered mechanical sheaths were used in 36 patients (72%), laser sheaths in 27 (54%), and a combination of laser and mechanical sheaths in 16 (32%).ConclusionsThe clinical and procedural success rates of TLE, primarily for CEID-related infection, were high. A combination of laser and mechanical sheaths was needed in one-third of patients.

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