Removing Conduction System Pacing Leads: Good Success So Far

Removing Conduction System Pacing Leads: Good Success So Far

BOSTON — Lead wires implanted for conduction system pacing have thus far been feasible to remove despite their more challenging characteristics, a multicenter study showed.

The leads were removed with manual traction alone in 91% of the 341 patients, with a rate of 90% for leads attached to the His bundle and 92% for those placed in the left bundle branch area, Pugazhendhi Vijayaraman, MD, of the Geisinger Heart Institute in Wilkes Barre, Pennsylvania, reported at the Heart Rhythm Society (HRS) annual meeting.

Another 8% of cases needed mechanical extraction, 2% required laser instruments, and 1% were done with femoral tools.

Removal was a complete success in 99% of cases, defined by full removal of targeted leads and all lead material from the vascular space without any permanently disabling complication or death. Vijayaraman called the complication rate low in this cohort.

However, the mean lead dwell time was 22 months, and even shorter on average for the leads with the newer left bundle branch area pacing approach (52%
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