ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2024
Comprehensive analysis of substernal lead removal: experience from EV ICD Pilot, Pivotal, and Continued Access Studies.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Retrosternal extravascular implantable cardioverter-defibrillators: a systematic review of implant characteristics, defibrillation testing, and acute safety.Future cardiology · 2026Pooled it
- Evaluation of a second-generation intercostal extravascular implantable cardioverter defibrillator lead with a pectoral pulse generator for sensing, defibrillation, and anti-tachycardia pacing.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Trial
- Performance and Safety of the Extravascular Implantable Cardioverter Defibrillator Through Long-Term Follow-Up: Final Results From the Pivotal Study.Circulation · 2025Trial
- Similarities and Differences Between the Extravascular and the Subcutaneous Implantable Cardioverter-Defibrillator: Sensing, Discrimination, and Complications (Part 2).Current cardiology reports · 2026Review
- Extravascular implantable cardioverter defibrillator lead fracture and challenges with revision.HeartRhythm case reports · 2026Article
- Initial Experience of the Medtronic Aurora Extravascular Implantable Cardioverter in Children in a UK Centre.Pediatric cardiology · 2026Article
- Article
- Isolated extravascular implantable cardioverter-defibrillator infection without leadless pacemaker involvement: A unique dual-device case report.HeartRhythm case reports · 2026Article
- Review
- The extravascular implantable defibrillator: a novel opportunity for the paediatric population.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Successfully escaping the pleura with the extra-vascular implantable cardioverter defibrillator lead: a case report.European heart journal. Case reports · 2025Article
- Extravascular Implantable Cardioverter-Defibrillators: A Systematic Review of Emerging Evidence.Cureus · 2025Review
- Unexpected posterior tilt in extravascular implantable cardioverter-defibrillator leads: Lessons learned from 3 cases.HeartRhythm case reports · 2025Article
- Uncomplicated Extravascular Implantable Cardioverter-Defibrillator Extraction After 4 Years Dwell Time: A Case Report.Journal of cardiovascular electrophysiology · 2025Article
Corrections and comments
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Authors and funding
18 authors.
Funding
Abstract
aimsThe extravascular implantable cardioverter-defibrillator (EV ICD) has been shown to be safe and effective for patients at risk of sudden cardiac death, but little is known about EV ICD lead removal in humans. This analysis aimed to characterize the EV ICD lead removal experience thus far. METHODS AND
resultsThis was a retrospective analysis of lead removals from the EV ICD Pilot, Pivotal, and Continued Access Studies. Patients with a successful EV ICD implant who underwent lead removal were included. The main objective was lead removal success. Ancillary objectives included characterizing technique used, procedure complications, and reimplantation status. An EV ICD system was successfully implanted in 347 patients across the 3 studies (25.9% female; 53.4 ± 13.3 years; left ventricular ejection fraction: 39.7 ± 15.9). Of these patients, 29 (8.4%) underwent lead removal with a mean lead dwell time of 12.6 ± 14.3 months (0.2-58.4). The main reason for lead removal was lead dislodgement (n = 9, 31.0%). Lead removal was successful in 27/29 (93.1%) cases [100% (19/19) success rate <1 year and 80% (8/10) success rate >1 year post-implant]. Simple traction was used in 22/26 (84.6%) and extraction tools in 4/26 (15.4%) successful cases where technique was known. No complications were reported for any of the removal procedures. All 11 EV ICD reimplant attempts were successful.
conclusionComplete removal of the EV ICD lead was successful in 93.1% of cases, and simple traction was sufficient in most instances. Based on these results, lead removal from the substernal space was safe and achievable up to 3 years post-implant.
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