Transvenous Lead Extraction of Cardiac Implantable Electronic Devices: Who, When, How and Where?

The use of cardiac implantable electronic devices (CIED) has greatly increased over the past 2 decades. In parallel, there has been a growing need for device and lead extraction. The subsequent development of tools, techniques, and standards for transvenous lead extraction (TLE) has improved both the safety and efficacy of these procedures. However, these remain complex interventions that require well trained personnel and a well-equipped facility with tools and strategies to deal with life-threatening complications, should they occur. In this condensed review, we discuss the topic of TLEs with an emphasis on the key elements including: a) qualifications of the primary operator; b) procedural indications and factors to account for in decision making, as well as the c) tools, and d) techniques for TLE: ‘‘The who, when, how and where?’’