In NHI transvenous lead extraction procedure is done 
according to the heart team lead extraction program 
where dedicated electrophysiologists always do the 
procedure according to our limited resources and 
finances. Managing each case as an entity begins with 
simple transvenous traction. application of medial
incision approach at the venous entry to overcome 
adhesions, uncoil loops, and set free the lead at its 
venous entry facilitating TLE. This approach was 
introduced by Professor Dr. Mohamed. Ossama lead 
extraction group creator and director at NHI.