Chapter 7 114 In case of lead malfunction, the dysfunctional lead usually comprised an ICD lead (62.1%), followed by an atrial lead (18.6%), right ventricular lead (13.6%) and coronary sinus lead (5.6%). Among 110 dysfunctional ICD leads, the three most common types were Biotronik Linox leads (33.6%), St. Jude Medical Riata leads (30.0%) and St. Jude Medical Durata leads (10.9%). In 31 patients with CIED-related systemic infection, the most common isolated pathogen was Staphylococcus aureus (48.4%). Other pathogens were coagulasenegative staphylococci (12.9%), aerobic Gram-positive non-staphylococci (12.9%), Gram-negative bacilli (12.9%), anaerobes (3.2%) and Mycobacterium species (3.2%). Two patients with a CIED-related systemic infection had negative blood cultures. 3.2 Procedural outcome An overview of procedural details is presented in Table 2. Most procedures were performed under general anesthesia. The three most common techniques used to perform the procedure were the use of a femoral snare as a primary tool (30%), combined powered sheath and femoral snare (25%) and traction only (20%) (Fig. 2). Thus, in the majority of the cases (54.5%), a femoral snare was used. The median number of targeted leads were 2 (1–2). The complete procedural success rate and clinical success rate was 90.2% and 97.7%, respectively. Complete lead removal rate was 94.1% of all targeted leads. A detailed overview of the 6 procedural failures is presented in Table 3. An overview of the procedural characteristics and outcome per indication group is presented in Fig. 3. Patients who underwent TLE with traction only had a higher complete procedural success rate than patients who required an extraction tool (98.1% versus 88.2%, P = 0.03). In contrast, the clinical success rate was similar between patients who underwent TLE with or without extraction tools (97.2% versus 98.1%, respectively, P = 1.00). The median dwelling time of the oldest targeted lead was shorter in patients who underwent TLE with traction only (3.3 [1.6–5.2] versus 7.9 [5.1–10.8] years, P < 0.001). General anesthesia was less often used in procedures were TLE was performed with manual traction only (42.3% versus 88.7%, P < 0.001).
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