Background:The number of patients undergoing cardiac resynchronization therapy has increased. Consequently, there is increased frequency in the removal and reimplantation of coronary venous (CV) leads due to infection or malfunction.

Methods and Results:A total of 345 consecutive patients referred for lead(s) extraction were reviewed. Of these, 34 patients who underwent a CV lead removal were investigated. The indications for CV leads removal were device-related infections in 29 patients and lead malfunctions in 5 patients. The average duration of the CV leads was 4.1±3.8 years. All CV leads were successfully removed without any major complications, except for 1 in-hospital death. Successful CV lead removal by simple traction (ST) was achieved in 21 patients (62%), whereas extraction tools were required in 13 patients (38%). Local infection and CV lead dwell time were significantly associated with successful ST (P=0.04 and P=0.014, respectively). CV lead re-implantation was successfully performed in 25 patients; however, a right-side approach was required in 92%, and occlusion/stenosis of the previous CV was observed in 80% of the patients.

Conclusions:CV lead removal is relatively successful and safe. The presence of local infection and a shorter lead duration may enable successful ST of a CV lead. However, the re-implantation procedure should be well prepared for the complexity related to the right-side approach and occlusion/stenosis of the previous CV.

背景：接受心脏再同步化治疗的患者数量有所增加。因此，由于感染或功能障碍，冠状静脉 (CV) 引线的移除和再植入频率增加。

方法和结果：共审查了 345 名被转诊进行导线拔除的连续患者。其中，对 34 名接受 CV 导线移除的患者进行了调查。CV 导联移除的适应症是 29 名患者的设备相关感染和 5 名患者的导联故障。CV 导联的平均持续时间为 4.1±3.8 年。除 1 例院内死亡外，所有 CV 导联均已成功移除，没有任何重大并发症。21 名患者 (62%) 成功通过简单牵引 (ST) 移除 CV 引线，而 13 名患者 (38%) 需要拔除工具。局部感染和 CV 导联停留时间与成功的 ST 显着相关（分别为 P = 0.04 和 P = 0.014）。25例患者成功完成CV导线再植入；然而，92% 需要右侧方法，

结论： CV导联去除相对成功且安全。局部感染的存在和较短的导联持续时间可能使 CV 导联的 ST 成功。然而，再植入程序应为与右侧入路和先前 CV 的闭塞/狭窄相关的复杂性做好充分准备。