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Current Cardiology Reports

To Extract or not To Extract? Navigating Lead Failure in Cardiac Devices

  • 01-12-2025
  • Pacemaker
  • Invasive Electrophysiology and Pacing (EK Heist and S Nedios, Section Editors)
Published in:
Authors
Eric W. Mills
Dingxin Qin
Theofanie Mela
Published in
Current Cardiology Reports | Issue 1/2025

Abstract

Purpose of Review

Lead failure in cardiac implantable electronic devices (CIEDs) presents a critical challenge in clinical electrophysiology. These failures can result in inappropriate therapies, ineffective pacing, and even life-threatening outcomes. Despite technological advances in device design, transvenous leads remain an important source of complications.

Recent Findings

Novel developments in lead extraction strategies including pre-procedure risk prediction instruments, estimation of short-term mortality after lead extraction procedure, use of new technologies including shock-wave lithotripsy to facilitate disruption of intravascular calcium, cardioneural ablation to avoid need for reimplantation of cardiac devices, and the use of leadless pacemaker/defibrillator systems followed transvenous extraction are discussed.

Summary

This review explores the underlying mechanisms of lead failure, highlighting notable cases such as the Riata and Fidelis recalls, and discusses the complex decision-making process surrounding lead abandonment, extraction, or replacement.
Title
To Extract or not To Extract? Navigating Lead Failure in Cardiac Devices
Authors
Eric W. Mills
Dingxin Qin
Theofanie Mela
Publication date
01-12-2025
Publisher
Springer US
Published in
Current Cardiology Reports / Issue 1/2025
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-025-02282-z
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This content is intended for healthcare professionals outside of the UK.

Independent Medical Education Grant:
  • Bayer HealthCare Pharmaceuticals Inc.
Learn more Link opens in a new window
Image Credits
Abstract graphic of layered, concentric circular shapes in bright green, pink, blue, and purple on a dark blue background. The rings and segments form a complex radial pattern without text/© Springer Health+ IME