Aims Owing to the increasing use of cardiac implantable electronic devices, there is a growing need for safe and effective techniques to manage device-related complications and lead dysfunction. Lead extraction remains a challenging procedure with inherent risks. We present the 30-day and long-term outcomes of lead extractions in the University Hospitals Leuven. Methods and results We report a retrospective cohort study of 176 patients admitted to the University Hospitals Leuven between January

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... 2005 and December 2011, for the transvenous extraction of 295 leads. Indications for extraction were lead dysfunction and device upgrade in 84 (47.7%), pocket infection in 61 (34.7%), and systemic infection in 31 patients (17.6%). Extraction was successful in 95.5% of patients with complete removal of the leads or only a minor fragment remaining. One fatal periprocedural complication occurred. Thirty-day mortality was 3.4% (n ¼ 6). Systemic infection was the only significant predictor of 30-day mortality [odds ratio (OR) 29.706; P ¼ 0.029]. A lower level of haemoglobin prior to extraction also tended to be related with a higher mortality, but this was not significant (OR 2.024; P ¼ 0.082). One-year mortality was 8.5% (n ¼ 15). Systemic infection (OR 9.727; P ¼ 0.009), a lower level of haemoglobin (OR 1.597; P ¼ 0.05), and a higher level of ureum (OR 1.021; P ¼ 0.017) prior to extraction were significant predictors of 1-year mortality. Systemic infection was associated with significantly higher 30-day (19%), 1-year (32%), and long-term (39%) mortality rates. Conclusion Lead extraction can be safely and successfully performed in the majority of patients, with limited life-threatening complications. However, lead extraction because of systemic infection is associated with a significantly higher risk of short-and