Strategic Decision-Making in Lead Extraction: Tackling Unique and Complex Scenarios-Strategic Decision-Making in Lead Extraction: Tackling Unique and Complex Scenarios

Video Transcription

Video Summary

The video features the proceedings from the 46th annual meeting of the Heart Rhythm Society in San Diego in 2025. Participants are encouraged to use the HRS 2025 mobile app for real-time Q&A during sessions. The session's focus includes discussions about lead extraction, a process that involves removing leads from heart devices, often due to site infections or lead failures. The first speaker, Dr. Sean Brocconi, emphasizes the challenges in deciding when to extract or abandon non-infected leads, highlighting a study showing a 22% lower rate of infection when leads are extracted rather than abandoned. Emily Zeitler's talk centers on extracting leads in tricuspid regurgitation, particularly prior to transcatheter tricuspid valve interventions (TTVI), highlighting the importance of multimodal imaging to assess whether the leads themselves contribute to valve issues. The necessity of removing or jailing leads (leaving leads in place during valve replacement) is debated, with considerations about the patient's health and procedural risks being pivotal. Dr. Parashit Sharma discusses extracting luminous leads, emphasizing their challenges and the need for more data on long-term extractability. Finally, Dr. Charles Henrickson explores the approach to large lead vegetations, often requiring aspiration or surgical intervention, depending on their size and associated risks. The session underscores the complexity of managing device leads and the importance of careful patient evaluation and engagement in decision-making.

Keywords

Heart Rhythm Society

lead extraction

HRS 2025

tricuspid regurgitation

multimodal imaging

luminous leads

lead vegetations

transcatheter tricuspid valve interventions

patient evaluation

device management