INTRODUCTION
In parallel to the increased use of cardiac implantable electronic devices (CIED), the electrophysiology society faced with device-related problems like device upgrade, device-related infection, electrode dysfunction, and dislodgement which should be managed with effective and reliable methods 1. Despite significant improvement over the last decade in transvenous lead extraction (TLE) technology, the procedure is still associated with a significant morbidity and mortality 2.
After implantation, transvenous leads are often encapsulated with fibrotic capsules which adheres to vascular and intra-cardiac tissue by different humoral and cellular mechanisms 1. Among various tools and methods, powered extraction devices are required in the removal of the chronically implanted leads 3. Rotational mechanical dilator sheaths are acting by dissection of the fibrotic tissue in which the electrodes connected using the threaded end portion of the system 4. Currently, two different mechanical dilator sheaths with variable technical properties were available in the market [Evolution® (Cook Medical, Bloomington, IN, USA) and TightRailTM (Spectranetics Corp., Colorado Springs, Colorado, USA) mechanical dilator sheaths]. Both TLE system revealed high efficacy rates and acceptable safety results 3,5. However, the comparative data are scarce among different types of powered extraction tools. Previous studies have presented the data of single TLE device in general5,6. There is only one small study regarding the comparison of different rotational mechanical dilators7.
Thus, we aimed to compare the safety and efficacy outcomes, and all-cause mortality at long-term follow-up in a large-scale study population who underwent TLE using two different rotational mechanical dilators sheaths.