Extraction of non-infected redundant pacing and defibrillator leads does not result in better patient outcomes

The introduction of dedicated tools for pacing and defibrillator lead extraction has resulted in relatively high success and low complication rates. The confidence this elicits has broadened the indications from device infections to non-functional or redundant leads and the latter make up an increasing share of extraction procedures. Proponents of extracting these leads point to the higher complication burden of lead extraction in patients with longstanding abandoned leads when compared one-to-one with extraction when these leads become redundant. However, this does not translate into better patient outcomes on a population level: complications are rare with properly abandoned leads and thus most patients will never be subjected to an extraction procedure and the ensuing complications. Therefore, not extracting redundant leads minimises the risk for the patients and avoids many expensive procedures.