Table 1.

Indications for lead extraction.

Indications reflect the balance between risk and benefit. Leads implanted for only a few years can be extracted with a low risk.

Long implant times, dual coil ICD leads, multiple leads and elderly age of the patient increase the risk. Extraction should never be half-hearted or technically insufficiently supported, as this can result in disintegrated or dislocated leads

Mandatory

• Lead-related (right-sided) endocarditis

• Pocket infection with signs or symptoms of systemic infection

• Local infection not responding to conservative therapy

Advisable

• Local infection of a pacemaker or ICD pocket

• Recurrent systemic infection of unknown origin in a pacemaker or ICD patient without signs of pocket infection or lead vegetations

Not advisable

• Superfluous non-functional leads that cannot be easily removed (implanted for longer than 6 to 12 months)