Safety and Efficacy of Right‐ Versus Left‐Sided Transvenous Lead Extraction

ABSTRACT 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.