Reimplantation and long-term mortality after transvenous lead extraction in a high-risk, single-center cohort.

Autor: Zsigmond EJ; Cardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Semmelweis u. 8, Szeged, 6725, Hungary., Miklos M; Cardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Semmelweis u. 8, Szeged, 6725, Hungary., Vida A; Cardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Semmelweis u. 8, Szeged, 6725, Hungary., Benak A; Cardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Semmelweis u. 8, Szeged, 6725, Hungary., Makai A; Cardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Semmelweis u. 8, Szeged, 6725, Hungary., Schvartz N; Cardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Semmelweis u. 8, Szeged, 6725, Hungary., Klausz G; Cardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Semmelweis u. 8, Szeged, 6725, Hungary., Hegedus Z; Heart Surgery Department, University of Szeged, Szeged, Hungary., Bogats G; Heart Surgery Department, University of Szeged, Szeged, Hungary., Saghy L; Cardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Semmelweis u. 8, Szeged, 6725, Hungary., Vamos M; Cardiac Electrophysiology Division, Department of Internal Medicine, University of Szeged, Semmelweis u. 8, Szeged, 6725, Hungary. vamos.mate@gmail.com.
Jazyk: angličtina
Zdroj: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing [J Interv Card Electrophysiol] 2023 Jun; Vol. 66 (4), pp. 847-855. Date of Electronic Publication: 2021 Mar 16.
DOI: 10.1007/s10840-021-00974-4
Abstrakt: Purpose: The use of cardiac implantable electronic devices (CIEDs) has increased significantly over the last decades. With the development of transvenous lead extraction (TLE), procedural success rates also improved; however, data regarding long-term outcomes are still limited. The aim of our study was to analyze the outcomes after TLE, including reimplantation data, all-cause and cause-specific mortality.
Methods: Data from consecutive patients undergoing TLE in our institution between 2012 and 2020 were retrospectively analyzed. Periprocedural, 30-day, long-term, and cause-specific mortalities were calculated. We examined the original and the revised CIED indications and survival rate of patients with or without reimplantation.
Results: A total of 150 patients (age 66 ± 14 years) with 308 leads (dwelling time 7.8 ± 6.3 years) underwent TLE due to pocket infection (n = 105, 70%), endocarditis (n = 35, 23%), or non-infectious indications (n = 10, 7%). All-cause mortality data were available for all patients, detailed reimplantation data in 98 cases. Procedural death rate was 2% (n = 3), 30-day mortality rate 2.6% (n = 4). During the 3.5 ± 2.4 years of follow-up, 44 patients died. Arrhythmia, as the direct cause of death, was absent. Cardiovascular cause was responsible for mortality in 25%. There was no significant survival difference between groups with or without reimplantation (p = 0.136).
Conclusions: Despite the high number of pocket and systemic infection and long dwelling times in our cohort, the short- and long-term mortality after TLE proved to be favorable. Moreover, survival without a new device was not worse compared to patients who underwent a reimplantation procedure. Our study underlines the importance of individual reassessment of the original CIED indication, to avoid unnecessary reimplantation.
(© 2021. Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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