Transvenous laser lead extraction in patients with congenital complete heart block

Douglas Darden, Bendelyn Asante Boateng, Andrew S. Tseng, Laith Alshawabkeh, Travis Pollema, Yong Mei Cha, Ulrika Birgersdotter-Green

Research output: Contribution to journalArticlepeer-review


Background: Data on lead management in patients with congenital complete heart block (CCHB) with cardiac implantable electronic devices are lacking. Objective: The purpose of this study was to describe the natural history and outcomes in patients with CCHB with cardiac implantable electronic devices undergoing transvenous lead extraction (TLE). Methods: Data on all attempted TLE procedures in patients with CCHB at 2 institutions between 2011 and 2021 were collected from a retrospective registry. Results: Overall, 16 patients (mean age at transvenous device implant 13.8 ± 4.7 years) were included. Before TLE, patients underwent an average of 2.25 ± 1.3 generator changes, 3 (19%) underwent cardiac resynchronization therapy upgrade, and 7 (44%) underwent a lead revision with subsequently abandoned leads. Mean patient age at TLE was 34.4 ± 9.4 years with a mean duration of lead implant of 19.2 ± 6.9 years. Lead malfunction (n = 11 [69%]) and infection (n = 5 [31%]) were the most common indications for TLE. A total of 38 leads were removed, with complete procedural success achieved in 14 of 16 (87.5%). Two (12.5%) major complications occurred, including right ventricular laceration and superior vena cava tear requiring sternotomies. All patients survived at 1-year follow-up. Conclusion: Patients with CCHB represent a unique cohort highlighted by several generator changes, lead revisions, and abandoned leads at a young age, along with a long duration of lead dwelling time and a high prevalence of lead malfunction requiring TLE. There may be a high risk of major complications during TLE, suggesting TLE should be performed only in experienced centers. Larger studies are needed to confirm these findings.

Original languageEnglish (US)
Pages (from-to)1158-1164
Number of pages7
JournalHeart rhythm
Issue number7
StatePublished - Jul 2022


  • Complications
  • Congenital complete heart block
  • Outcomes
  • Pacemaker
  • Transvenous lead extraction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


Dive into the research topics of 'Transvenous laser lead extraction in patients with congenital complete heart block'. Together they form a unique fingerprint.

Cite this