ABSTRACT
Percutaneous intravascular lead extraction has evolved from simple traction through a weight-and-pulley system to a more advanced modern day laser and radiofrequency technique. A more invasive open-heart surgical technique through a midline sternotomy or a limited atriotomy technique was developed, and continues to be a last resort answer to difficult lead extractions that are not suitable for percutaneous techniques.1,2
Lead extractions are probably one of the most challenging procedures that a cardiac electrophysiologist has to face today. The indication for device implants has risen tremendously in the last years, and the associated complications that require interventions are expected to rise also. The potential for life-threatening complications like lead breakage, venous or myocardial tear, and tamponade makes lead extraction the least favorable procedure even to the most experienced hands.
