Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May-Jun;22(3):123-128.
doi: 10.1016/j.ipej.2022.02.021. Epub 2022 Feb 24.

Transvenous Lead Extraction (TLE) Procedure: Experience from a Tertiary Care Center in Thailand

Natcha Soontornmanokati  1 , Chulaporn Sirikhamkorn  2 , Nilubon Methachittiphan  3 , Kumpol Chintanavilas  4 , Sanatcha Apakuppakul  5 , Tachapong Ngarmukos  6 , Sirin Apiyasawat  7 , Wachara Lohawijarn  8 , Pakorn Chandanamattha  9
Affiliations

Transvenous Lead Extraction (TLE) Procedure: Experience from a Tertiary Care Center in Thailand

Natcha Soontornmanokati et al. Indian Pacing Electrophysiol J. 2022 May-Jun.

Abstract

Background: Transvenous Lead Extraction (TLE) is a standard treatment for some late Cardiac Implantable Electronics Device (CIED) complications. The outcome of transvenous lead extraction procedure in Thailand is not robust.

Methods: A Single-center retrospective cohort of TLE procedures performed at Ramathibodi hospital between January 2008 and December 2020 was studied.

Results: There were 157 leads from 105 patients who underwent lead removal procedure during the specified period. Data analysis was performed from 79 TLE patients due to incomplete data and lead explant procedure of the excluded subjects. Mean patients' age was 57.7 ± 18.7 years, with 70.9% male. There were 82 pacemaker leads, 35 ICD leads, and 5 CS leads (mean number of leads were 1.54 ± 0.66 per patient), with mean implanted duration of 87.8 ± 68.2 months. Main indication for TLE was infection-related, which accounted for 67.1% of the cases. Overall clinical success rate was 97.5%. Mean operative time was 163.8 ± 69.5 min. Major complications occurred in 4 patients (5.1%) with one in-hospital mortality from severe sepsis.

Conclusion: TLE using laser sheath and rotating mechanical sheath for transvenous lead extraction is effective and safe, even outside high-volume center.

Keywords: CIED infection; Laser lead extraction; Transvenous lead extraction.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest Authors declare no conflict of interest for this article.

Figures

Fig. 1
Fig. 1
The patient was under general anesthesia. Transesophageal echocardiogram (TEE) was used for intraprocedural monitoring. A laser sheath was inserted via right axillary vein for right sided pacemaker lead.
Fig. 2
Fig. 2
Microbiology of transvenous lead extraction from 37 patients in 2008-2020.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Korkerdsup T., Ngarmukos T., Sungkanuparph S., Phuphuakrat A. Cardiac implantable electronic device infection in the cardiac referral center in Thailand: incidence, microbiology, risk factors, and outcomes. J Arrhythm. 2018;34(6):632–639. - PMC - PubMed
    1. Uslan D.Z., Sohail M.R., St Sauver J.L., Friedman P.A., Hayes D.L., Stoner S.M., et al. Permanent pacemaker and implantable cardioverter defibrillator infection: a population-based study. Arch Intern Med. 2007;167(7):669–675. - PubMed
    1. Cohen T.J., Asheld W.J., Germano J., Islam S., Patel D. A comparative study of defibrillator leads at a large-volume implanting hospital: results from the pacemaker and implantable defibrillator leads survival study ("PAIDLESS") J Invasive Cardiol. 2015;27(6):292–300. - PubMed
    1. Maytin M., Daily T.P., Carillo R.G. Virtual reality lead extraction as a method for training new physicians: a pilot study. Pacing Clin Electrophysiol. 2015;38(3):319–325. - PubMed
    1. Smith M.C., Love C.J. Extraction of transvenous pacing and ICD leads. Pacing Clin Electrophysiol. 2008;31(6):736–752. - PubMed