Explantation of chronically implanted pacemaker or defibrillator leads can be technically demanding. We present the results of the first 44 leads extracted with excimer laser sheaths in 25 patients with a median lead implantation time of 7 years (range: 2 to 20 years). Indications for extraction were lead fracture in 17 patients, pocket infection in 4, septicemia in 2, and lead endocarditis in 2 cases. Complete extraction was achieved in 43 leads (97.7%), while the lead tip (< 4 cm) was abandoned in 1 case. There was no in-hospital mortality. The excimer laser-assisted system is a safe and efficient alternative for pacemaker and defibrillator lead extraction. This technology has resulted in excellent outcomes in our series, allowing us to treat remarkably difficult cases.
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