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Objective: The growing population and broadening indications have led to a surge in cardiovascular implantable electronic devices (CIEDs) implantations. Concurrently, there is a rising need for lead extractions due to various reasons. Yet, there is a lack of studies highlighting the immediate impact of lead removal on right ventricular (RV) functions. This study aims to evaluate the immediate effects of lead extraction on RV functions using strain echocardiography.
Methods: A total of 64 patients were included, who were scheduled for CIED lead extractions due to various reasons, and were admitted to the cardiology service or coronary intensive care unit. Detailed physical examinations were conducted, routine blood tests and wound and blood cultures were collected. All patients underwent detailed transthoracic echocardiography upon admission and within 24 hours post lead removal. Right ventricular functions in TTE were assessed using 2-dimensional Doppler and strain/ strain rate echocardiography.
Results: The mean age of the study participants was 61.3 ± 15 years, with 51 (79.7%) being male. The primary reasons for battery removal were infection in 89.1% (n=57) and lead dysfunction in 10.9% (n=7). Transthoracic echocardiography results indicated a significant reduction in strain echocardiography at the base of the RV free wall (−20.5% vs. −18.6%, P < .001) and the apex (−17.4% vs. −16%, P < .001) post procedure. There was also a notable decrease in the tricuspid annular plane systolic excursion post procedure (1.6 vs. 1.5 cm, P < .016).
Conclusion: Lead extraction results in an acute decline in RV function, making it essential for clinicians to anticipate complications such as hypotension, dizziness, congestion, and syncope post-extraction in CIED patients and tailor treatments accordingly.
Cite this article as: Özbebek YE, Aslan AN, Çöteli C, et al. Evaluation of right ventricular function in the acute period following lead extraction by strain echocardiography in patients with implantable electronic devices. Arch Basic Clin Res. 2025;7(1):1-8.