Safety and Efficacy of Right- Versus Left-Sided Transvenous Lead Extraction.

BACKGROUND AND AIMS: Transvenous lead extraction (TLE) is increasingly performed for malfunction or infection of cardiac implantable electronic devices. Because of anatomic differences, TLE for right-sided (RS) electrodes may differ in outcome. This study aimed to evaluate whether RS TLE differs in patient characteristics and outcomes compared to left-sided TLE. METHODS: We retrospectively analyzed patients who underwent TLE at the University Hospital Zurich from 2013 until 2023 regarding clinical and radiological success and complications. RESULTS: A total of 556 patients underwent 568 TLE from January 2013 until December 2023. Patients with RS TLE procedures (n = 147, 25.9%) were older, more often PM-dependent, had longer lead dwell time, more leads with passive fixation and were more often extracted for infection. RS TLE procedures had a longer procedure duration (130 vs. 108 min, p = 0.002), more often needed a snare-bailout strategy (22% vs. 10%, p = 0.0.45), resulted in lower radiological success rates (88.4% vs. 93.8%, p = 0.045) and more major as well as minor complication rates. CONCLUSION: In our retrospective single-center analysis, RS TLE Procedures were more challenging concerning patient characteristics and resulted in lower TLE success as well as higher complication rates.