Current practice in Transvenous Lead Extraction in Latin-American:
Latin-American Heart Rhythm Association Survey
Abstract
Background: Transvenous lead extraction (TLE) is standard of care for
the management of patients with cardiac implantable electronic device
infection or lead related complications. Currently, objective data on
TLE in Latin America is lacking. Objective: To describe the current
practice standards in Latin American centers performing TLE. Methods: An
online survey was sent through the mailing list of the Latin American
Heart Rhythm Association (LAHRS). Online reminders were sent through the
mailing list; duplicate answers were discarded. The survey was available
for one month, after which no more answers were accepted. Results: A
total of 48 answers were received, from 44 different institutions
(39.6% from Colombia, 27,1% from Brazil), with most respondents (83%)
being electrophysiologists. Twenty-nine institutions (66%) performed
less than 10 lead extractions/year, with 7 (15%) institutions not
performing lead extraction. Although most institutions in which lead
extraction is performed reported using several tools, mechanical
rotating sheaths were cited as the main tool (73%), 13.5% reported the
use of mechanical extraction sheaths and only 13.5% reporting the use
of laser sheaths. Management of infected leads was performed according
to current guidelines. Conclusion: This survey is the first attempt to
provide information on TLE procedures in Latin America and could provide
useful information for future prospective registries. According to our
results, the number of centers performing high volume lead extraction in
Latin America is smaller than that reported in other continents, with
most interventions performed using mechanical tools. Future prospective
registries assessing acute and long-term success are needed.