Proposed clinical scenarios
Answers to proposed clinical scenarios (including high-risk lead
extraction procedures the management CIED pocked infections and
malfunctioning leads) were received from the 42 respondents who
performed lead extraction. Although the majority of respondents (30,
71%) had no specific clinical scenarios in which lead extraction would
be avoided, 10 (24%) respondents reported avoiding lead extraction in
patients over 80 years of age (3A). In cases of device related pocket
infection, total capsulectomy was performed by 24 (57%), with 9 (24%)
reporting not performing capsulectomy (figure 3B). In pacing dependent
patients with isolated pocket infection (figure 3C), a new device was
implanted only after consultation with the infectious disease specialist
by 18 (43%) of respondents, with 5 respondents (12%) reporting
implantation of a new device during the same procedure. In patients with
malfunctioning pacemaker or ICD leads, lead abandonment within the
generator pocket (with implantation of a new lead) was routinely
performed by 3 respondents (7%), while 30 (71%) respondents basing
their decision on a case-by-case basis after analyzing individual
patient characteristics and comorbidities (figure 3D)