Extraction of lumen less pacing leads from the His Bundle and left bundle branch area - outcomes of the high volume center

The application of conduction system pacing (CSP) in clinical practice is growing, and the need for lead extraction will also increase. The data on outcomes and safety of CSP lead extraction are limited. The aim of this study was to assess procedural outcomes and safety of CSP lead removal. Forty-seven patients from the EXTRACT Registry with the indication for CSP lead removal were enrolled in the study conducted at the Department of Electrocardiology in Katowice, Poland. Extraction technique, outcomes, safety, and complication were evaluated. Forty-three (91.5%) leads were successfully removed, and 41 (87.2%) were removed with traction only. The dwelling time of 28 extracted leads was longer than one year, and the oldest extracted lead was implanted for 89 months. Seven (14.9%) leads were removed from the left bundle branch area and 36 from the His bundle. Transient complete AV block occurred during the procedure in two patients. In 27 out of 31 attempts (87.1%), new CSP leads were implanted: nine (33.3%) His bundle pacing leads and 18 (66.7%) left bundle branch area pacing leads. The CSP lead extraction is safe and feasible with a low complication rate and high rate of CSP lead reimplantation.