Transvenous lead extraction – summary of the experience of a single Bulgarian center – a retrospective study

There has been increased rate of cardiac implantable electronic devices (CIED) implanted worldwide. Respectively the numbers of patients with absolute indications for lead extraction (pacemaker and ICD) grow up exponentially. The aim of our study is to present the initial experience and long-term results of pacemaker and ICD lead extraction in patients treated in Cardiology department of University hospital “Sveta Anna” Sofi a. Material and Methods: Retrospective study was performed of patients with CIED implanted greater than 1 year and indications for lead extraction. Clinical and procedural characteristics, success rate, complications rate, and reinfection rate data were collected and analyzed. Results: In the period August 2016 to May 2021, a total of 54 patients were admitted to our department with an absolute indication for lead extraction. A total of 114 pacemakers and ICD electrodes were extracted during 54 procedures. In 47 patients (87%) was shown complete technical success with removal of all hardware and in 53 patients (98.1%) clinical success of the procedure was found. The incidence of major periprocedural complications requiring urgent cardiac surgery in our series was 2 (3.7%). Follow-up revealed a very low recurrence infection rate – only 1 patient (1.9%). Conclusion: Lead extraction is a safe and effective procedure. The establishment of a specialized center with an organized system for lead extraction is key in achieving excellent short- and long-term results.