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Procedural outcomes associated with transvenous lead extraction in patients with abandoned leads: an ESC-EHRA ELECTRa (European Lead Extraction ConTRolled) Registry Sub-Analysis

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  • Luca Segreti
  • Christopher A Rinaldi
  • Simon Claridge
  • Jesper Hastrup Svendsen
  • Carina Blomstrom-Lundqvist
  • Angelo Auricchio
  • Christian Butter
  • Nikolaos Dagres
  • Jean-Claude Deharo
  • Aldo P Maggioni
  • Andrzej Kutarski
  • Charles Kennergren
  • Cecile Laroche
  • Maciej Kempa
  • Andrea Magnani
  • Benjamin Casteigt
  • Maria Grazia Bongiorni
  • ELECTRa Investigators
Vis graf over relationer

AIMS: The decision to abandon or extract superfluous leads remains controversial. We sought to compare procedural outcome of patients with and without abandoned leads undergoing transvenous lead extraction (TLE).

METHODS AND RESULTS: An analysis of the ESC-EHRA European Lead Extraction ConTRolled ELECTRa registry was conducted. Patients were stratified into two groups based on the presence (Group 1) or absence (Group 2) of abandoned leads at the time for extraction. Out of 3508 TLE procedures, 422 patients (12.0%) had abandoned leads (Group 1). Group 1 patients were older and more likely to have implantable cardioverter-defibrillator devices, infection indication (78.8% vs. 49.8%), and vegetations (24.6% vs. 15.3%). Oldest lead dwelling time was longer in Group 1 (10.9 vs. 6.3 years) as was the number of extracted leads per patient (3.2 vs. 1.7). Manual traction failure (94.5% vs. 78.8%), powered sheath use (50.7% vs. 28.4%), and femoral approach were higher in Group 1 (P < 0.0001). Procedural success rate and clinical success (89.8% vs. 96.6%, P < 0.0001) were lower in Group 1. Major complication including deaths (5.5% vs. 2.3%, P = 0.0007) and procedure related major complications (3.3% vs. 1.4%, P = 0.0123) were higher in Group 1. The presence of abandoned leads at the time of TLE was an independent predictor of clinical failure [odds ratio (OR) 2.31, confidence interval (CI) 1.57-3.40] and complications [OR 1.69, CI 1.22-2.35]. receiver-operating characteristic curve analysis showed a dwell time threshold of 9 years for radiological failure and major complications.

CONCLUSIONS: Previously abandoned leads at the time of TLE were associated with increased procedural complexity, clinical failure, and major complication, which may have important implications for future studies regarding managing of lead failures.

OriginalsprogEngelsk
TidsskriftEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
Vol/bind21
Udgave nummer4
Sider (fra-til)645-654
Antal sider10
ISSN1099-5129
DOI
StatusUdgivet - 1 apr. 2019

Bibliografisk note

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.

ID: 57659829