Outcomes of repeated transvenous lead extraction

Haixia Fu, Gordon Ho, Mei Yang, Xinmiao Huang, Erin A. Fender, Siva Mulpuru, Roshini Asirvatham, Victor G. Pretorius, Paul A. Friedman, Ulrika Birgersdotter-Green, Yong Mei Cha

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Introduction: The outcomes of repeated cardiovascular implantable electronic device (CIED) lead extraction have not been well studied. We sought to determine the indications, outcomes, and safety of repeated lead extraction procedures. Methods: This retrospective study was conducted using data from two medical centers, including 38 patients who had undergone two or more lead extraction procedures compared to 439 patients who had a single procedure. The electronic medical records and procedural databases were reviewed to determine the indications, procedural characteristics, and outcomes. The outcomes of the first procedure were compared to the outcomes of subsequent procedures. Results: The 5-year cumulative probability of a repeated extraction procedure was 11% (95% confidence interval, 7%–15%). In 439 patients who underwent single lead extractions, 72% had device and lead related infections as the procedure indication compared to 39% for 38 patients who underwent repeated extraction (P < 0.001). The mean duration from device reimplant to repeated extraction procedures was 63 ± 48 months. Ninety-eight percent of the leads were removed completely in repeated procedures, similar to the 95% success rate of the first procedure (P = 0.51). There was no significant difference in major complication rate in the first or repeated extractions (2.6% vs 5.2%, P = 0.79). Conclusions: Repeated transvenous lead extraction is not uncommon. It had a high success rate comparable to that of the initial procedure and was not associated with an increased incidence of adverse events.

Original languageEnglish (US)
Pages (from-to)1321-1328
Number of pages8
JournalPACE - Pacing and Clinical Electrophysiology
Volume41
Issue number10
DOIs
StatePublished - Oct 2018

Keywords

  • ICD lead
  • cardiovascular implantable electronic device
  • lead extraction
  • pacemaker lead

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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