Lead extraction outcomes in patients with congenital heart disease

Erin A. Fender, Ammar M. Killu, Bryan C. Cannon, Paul Andrew Friedman, Christopher J. Mcleod, David O. Hodge, Craig S. Broberg, Charles A. Henrikson, Yong-Mei Cha

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Aims: Patients with congenital heart disease (CHD) are at increased risk for intracardiac device malfunction and infection that may necessitate extraction; however, the risk of extraction is poorly understood. This study addresses the safety of extraction in patients with structural heart disease and previous cardiac surgery. Methods and results: This retrospective study included 40 CHD and 80 matched control patients, who underwent transvenous lead extractions between 2001 and 2014. Only leads >12 months were included. There were 77 leads in CHD patients and 146 in controls. The mean age was 38 ± 16 years in CHD patients. Ninety per cent of CHD patients had ≥1 cardiac surgeries when compared with 21% of controls (P < 0.001). The number of abandoned leads was significantly different (17 vs. 3, P < 0.001). Lead age was similar with an average duration of 83 ± 87 months in CHD patients and 62 ± 65 months in controls (P = 0.24). There was no significant difference in extraction techniques. Manual traction was successful in 40% of CHD patients and 47% of controls, and advanced techniques were used in 60 and 53% of CHD patients and controls, respectively. Complete extraction was achieved in 94% of the patients in both groups. There was no significant difference in complications. Conclusion: Lead extraction can be safely performed in patients with CHD. Despite anatomic abnormalities and longer implantation times, the difficulty of lead extraction in patients with CHD is comparable with controls.

Original languageEnglish (US)
Pages (from-to)441-446
Number of pages6
JournalEuropace
Volume19
Issue number3
DOIs
StatePublished - 2017

Keywords

  • Cardiac implantable electronic device
  • Congenital heart disease
  • Laser lead extraction
  • Lead extraction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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