Transvenous lead extraction in patients with cardiac implantable device : the impact of systemic and local infection on clinical outcomes-an ESC-EHRA ELECTRa (European Lead Extraction Controlled) registry substudy
| Autor: | Igor, Diemberger, Luca, Segreti, Christopher A, Rinaldi, Jesper Hastrup, Svendsen, Andrzej, Kutarski, Arwa, Younis, Cécile, Laroche, Christophe, Leclercq, Barbara, Małecka, Przemyslaw, Mitkowski, Maria Grazia, Bongiorni, On Behalf Of The ELECTRa Investigators |
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| Přispěvatelé: | Diemberger I., Segreti L., Rinaldi C.A., Svendsen J.H., Kutarski A., Younis A., Laroche C., Leclercq C., Malecka B., Mitkowski P., Bongiorni M.G. |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Biology; Volume 11; Issue 4; Pages: 615 Diemberger, I, Segreti, L, Rinaldi, C A, Svendsen, J H, Kutarski, A, Younis, A, Laroche, C, Leclercq, C, Małecka, B, Mitkowski, P & Bongiorni, M G 2022, ' Transvenous Lead Extraction in Patients with Cardiac Implantable Device : The Impact of Systemic and Local Infection on Clinical Outcomes-An ESC-EHRA ELECTRa (European Lead Extraction Controlled) Registry Substudy ', Biology, vol. 11, no. 4, 615 . https://doi.org/10.3390/biology11040615 |
| Popis: | Background: Infections of cardiac implantable devices (CIEDI) have poor outcomes despite improvement in lead extraction (TLE) procedures. Methods: To explore the influence of CIEDI on the outcomes of TLE and the differences between patients with systemic (Sy) vs. local (Lo) CIEDI, we performed a sub-analysis of the EORP ELECTRa (European Lead Extraction ConTRolled) Registry. Results: Among 3555 patients enrolled by 73 centers in 19 Countries, the indication for TLE was CIEDI in 1850: 1170 with Lo-CIEDI and 680 with Sy-CIEDI. Patients with CIEDI had a worse in-hospital prognosis in terms of major complications (3.57% vs. 1.71%; p = 0.0007) and mortality (2.27% vs. 0.49%; p < 0.0001). Sy-CIEDI was an independent predictor of in-hospital death (H.R. 2.14; 95%CI 1.06–4.33. p = 0.0345). Patients with Sy-CIEDI more frequently had an initial CIED implant and a higher prevalence of comorbidities, while subjects with Lo-CIEDI had a higher prevalence of previous CIED procedures. Time from signs of CIEDI and TLE was longer for Lo-CIEDI despite a shorter pre-TLE antibiotic treatment. Conclusions: Patients with CIEDI have a worse in-hospital prognosis after TLE, especially for patients with Sy-CIEDI. These results raise the suspicion that in a relevant group of patients CIEDI can be systemic from the beginning without progression from Lo-CIEDI. Future research is needed to characterize this subgroup of patients. |
| Databáze: | OpenAIRE |
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