Sidi M'hamed Ely, Taleb Issa Mohamed Lemine, Ould Cheikhna Youssef, Jemal Kheyi
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 10
Date of Publication: 2026/10/16
Background: Infection of cardiac implantable electronic devices (CIEDs) requires complete
system removal. Data on transvenous lead extraction (TLE) from North African centers
remain scarce.
Objective: To describe the clinical profile, procedural outcomes, and complications of TLE
for CIED infection in a Moroccan tertiary center.
Methods: We conducted a single-center observational study of all consecutive patients who
underwent TLE for CIED infection at the Mohammed V Military Teaching Hospital, Rabat,
between January 2018 and June 2026. Procedural data were recorded prospectively; clinical
data were completed retrospectively from medical records. Outcomes were defined according
to Heart Rhythm Society criteria.
Results: Forty patients (mean age 68 years, range 45–92; 67.5% men) underwent 40
procedures for the removal of 76 leads. The mean lead dwell time was 96 ± 59.5 months, and
82.5% of patients had leads implanted for more than 5 years. Lead-related infective
endocarditis was present in 23 patients (57.5%), and vegetations were seen on
echocardiography in 19 (47.5%). Blood cultures were positive in 21 patients (52.5%), mostly
with Staphylococcus aureus (9/21). Extraction used laser sheaths in 21 procedures (52.5%)
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and simple traction in 19 (47.5%). Complete procedural success was achieved in 82.5% and
clinical success in 92.5%. Complete radiological success was obtained for 81.6% of leads and
partial success for 13.2%. Major intraprocedural complications occurred in two patients
(5.0%), including one death from a superior vena cava tear (2.5%). Thirty-day mortality was
5.0%. Longer lead dwell time was associated with lower radiological success.
Conclusion: TLE for CIED infection is feasible in our setting, with outcomes close to, though
slightly below, those of high-volume centers. Wider access to powered sheaths, rescue
balloons, and on-site surgical backup could further improve safety.
Keywords: cardiac implantable electronic device; infective endocarditis; lead extraction;
excimer laser; pacemaker; implantable cardioverter-defibrillator; complications; Morocco
cardiac implantable electronic device; infective endocarditis; lead extraction; excimer laser; pacemaker; implantable cardioverter-defibrillator; complications; Morocco
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