LAUSR

OBJECTIVES The purpose of this study was to examine the factors affecting the outcome of successful lead extraction with an excimer laser sheath, which have not been clearly elucidated. METHODS Between January 2011 and December 2016 in our institution, 372 leads were intravenously extracted from 176 patients (mean age, 67 ± 15 years; 83% male) with the use of an excimer laser sheath. The mean time since lead implantation was 7.1 ± 6.7 years. Indications for this procedure were infection (76.1%), non-functional lead (11.3%), functional lead (9.7%) and others (2.9%). RESULTS The clinically successful removal rate was 96%. The procedural failure group had a longer time from implantation (P = 0.01), longer fluoroscopy time (P < 0.01) and greater use of a single-lead atrioventricular synchronous (VDD) pacing lead (P < 0.01) compared to the clinical success group. The significant factors of clinical failure were the use of a VDD-pacing lead (odds ratio 30.9, 95% confidence interval 5.8-165; P < 0.01) and the time from first implantation (odds ratio 1.1, 95% confidence interval 1.0-1.3; P = 0.02). In addition, there was no significant difference between the use of a VDD-pacing lead and the time from first implantation (P = 0.28). CONCLUSIONS A VDD-pacing lead is an unsuccessful factor of lead extraction. When performing VDD-pacing lead extraction, an operator should pay special attention to the procedure.