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 Andrew Friedman, Ulrika Birgersdotter-Green, Yong-Mei Cha

Research output: Contribution to journalArticle

1 Citation (Scopus)

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)
JournalPACE - Pacing and Clinical Electrophysiology
DOIs
StateAccepted/In press - Jan 1 2018

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Equipment and Supplies
Lead
Electronic Health Records
Retrospective Studies
Databases
Confidence Intervals
Safety
Incidence
Infection

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Outcomes of repeated transvenous lead extraction. / Fu, Haixia; Ho, Gordon; Yang, Mei; Huang, Xinmiao; Fender, Erin A.; Mulpuru, Siva; Asirvatham, Roshini; Pretorius, Victor G.; Friedman, Paul Andrew; Birgersdotter-Green, Ulrika; Cha, Yong-Mei.

In: PACE - Pacing and Clinical Electrophysiology, 01.01.2018.

Research output: Contribution to journalArticle

Fu, H, Ho, G, Yang, M, Huang, X, Fender, EA, Mulpuru, S, Asirvatham, R, Pretorius, VG, Friedman, PA, Birgersdotter-Green, U & Cha, Y-M 2018, 'Outcomes of repeated transvenous lead extraction', PACE - Pacing and Clinical Electrophysiology. https://doi.org/10.1111/pace.13464
Fu, Haixia ; Ho, Gordon ; Yang, Mei ; Huang, Xinmiao ; Fender, Erin A. ; Mulpuru, Siva ; Asirvatham, Roshini ; Pretorius, Victor G. ; Friedman, Paul Andrew ; Birgersdotter-Green, Ulrika ; Cha, Yong-Mei. / Outcomes of repeated transvenous lead extraction. In: PACE - Pacing and Clinical Electrophysiology. 2018.
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AU - Huang, Xinmiao

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AU - Asirvatham, Roshini

AU - Pretorius, Victor G.

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N2 - 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.

AB - 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.

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KW - ICD lead

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