9. Pacemakers: Clinical Results, Practical Aspects and Late-Break Clinical Trials: 9.7 Safety and Efficacy of Percutaneous Extraction of Endocardial Pacing Leads in Children and Adults with Congenital Heart Disease (CHD) Free

Retrospective data analysis of percutaneous pacing lead extractions of a single centre (November 1998 - November 2004).

25 patients (20 children) undergoing 27 lead extractions were identified with mean age 14.7yr (0.1 – 46 .1), mean weight 43.5 kg (3.4-88kg). Indications for pacemaker were complete heart block (20; post-surgery 14, congenital 6), defibrillator implants (2), antitachycardia pacing (2), and sinus node dysfunction (1). Indications for lead extraction were taut lead (6), high thresholds (5), insulation break (4), infection (4) and others (6). The mean duration of lead dwell time was 48.6 months (1 day –124 months).

Average procedure time was 212 minutes (40 – 630 minutes) and screening time 29.5 minutes (1.3-80 minutes). Extraction stylets were used in 17 patients (Wilkoff 5, Liberator 12). Radiofrequency cutting sheathe was used in 11 and needle-eye snare in 2. Complete success achieved in 25/27 lead extractions.

There were no major complications (embolism, myocardial avulsion, lead migration, haemothorax, cardiac tamponade, or death).

Percutaneous endovascular lead extraction procedures can be performed with excellent safety and success in patients with CHD.