An Enhanced Method for Left Bundle Branch Area Pacing Lead Extraction Using Continuous Femoral Pigtail Countertraction
Abstract
1. Introduction
2. Case Presentations
2.1. Extraction Technique
2.2. Postprocedural Course
3. Discussion
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
CIEDs | Cardiac implantable electronic devices |
CRT-D | Cardiac resynchronization therapy with deffibrilation therapy |
EF | Ejection fraction |
LBBAP | Left bundle branch area pacing |
HPB | His bundle pacing |
TEE | Trans-esophageal echo-cardiograph |
RA | Right atrium |
RV | Right ventricle |
SVC | Superior vena cava |
VVI | Unicameral pacemaker |
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Study (Citation) | Design and Population | Lead Type and Dwell Time | Extraction Tools Used | Success and Outcome | Complications and Notes |
---|---|---|---|---|---|
Vijayaraman et al. [22] | Retrospective, international multicenter (10 centers), with 341 patients. | 224 His-bundle, 117 LBBAP; mean dwell 22 ± 26 mo. | Manual (most); mechanical in 10% (>6 mo), laser in 3%, femoral tools in 3 cases. | Complete procedural success 99%; clinical 100% (3 patients retained fragments); re-implantation success 95%. | Minor complications in 2.1%; low need for advanced tools; dwell mostly <3 yrs. |
Migliore et al. [23] | Single-center, 6 patients, 17 leads (Italy); mixed His/LBBP. | 3830 lumenless leads; mean dwell 97 ± 90 mo (8–193 mo). | Manual successful in 2; evolution RL mechanical sheath in others. | 94% complete extraction; 1 minor remnant; no major complications; median follow-up 15 ± 13 mo. | One femoral AV fistula; no conduction damage or septal defect. |
Wagner et al. [24] | Multicenter observational (cited in Heart Rhythm abstract). | Likely His + LBB leads; details not in abstract. | Not specified in summary. | Not specified—full text needed. | Not tracked in abstract; presumably similar outcomes. |
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Rosu, A.M.; Badea, T.G.; Tomescu, F.L.; Radu, E.S.; Tanasescu, M.-D.; Cismas, E.G.; Popa, O.A. An Enhanced Method for Left Bundle Branch Area Pacing Lead Extraction Using Continuous Femoral Pigtail Countertraction. Diagnostics 2025, 15, 2198. https://doi.org/10.3390/diagnostics15172198
Rosu AM, Badea TG, Tomescu FL, Radu ES, Tanasescu M-D, Cismas EG, Popa OA. An Enhanced Method for Left Bundle Branch Area Pacing Lead Extraction Using Continuous Femoral Pigtail Countertraction. Diagnostics. 2025; 15(17):2198. https://doi.org/10.3390/diagnostics15172198
Chicago/Turabian StyleRosu, Andrei Mihnea, Theodor Georgian Badea, Florentina Luminita Tomescu, Emanuel Stefan Radu, Maria-Daniela Tanasescu, Eduard George Cismas, and Oana Andreea Popa. 2025. "An Enhanced Method for Left Bundle Branch Area Pacing Lead Extraction Using Continuous Femoral Pigtail Countertraction" Diagnostics 15, no. 17: 2198. https://doi.org/10.3390/diagnostics15172198
APA StyleRosu, A. M., Badea, T. G., Tomescu, F. L., Radu, E. S., Tanasescu, M.-D., Cismas, E. G., & Popa, O. A. (2025). An Enhanced Method for Left Bundle Branch Area Pacing Lead Extraction Using Continuous Femoral Pigtail Countertraction. Diagnostics, 15(17), 2198. https://doi.org/10.3390/diagnostics15172198