Luca Segreti1, Christopher A Rinaldi2, Simon Claridge2, Jesper Hastrup Svendsen3, Carina Blomstrom-Lundqvist4, Angelo Auricchio5, Christian Butter6, Nikolaos Dagres7, Jean-Claude Deharo8, Aldo P Maggioni9,10, Andrzej Kutarski11, Charles Kennergren12, Cecile Laroche10, Maciej Kempa13, Andrea Magnani14, Benjamin Casteigt15, Maria Grazia Bongiorni16. 1. Cardiology Department, University Hospital of Pisa, Via Paradisa 2, Pisa, Italy. 2. Cardiology Department, Guy's & St Thomas' Hospitals, London, UK. 3. Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 4. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 5. Department of Medical Science and Cardiology, Uppsala University, Uppsala, Sweden. 6. Cardiology Department, Fondazione Cardiocentro Ticino, Lugano, Switzerland. 7. Department of Cardiology, Heart Center Brandenburg in Bernau/Berlin & Brandenburg Medical School, Germany. 8. Department of Electrophysiology, Heart Center Leipzig, Germany. 9. CHU La Timone, Cardiologie, Service du prof Deharo, 264 Rue Saint Pierre, Marseille, France. 10. ANMCO Research Center, Florence, Italy. 11. Scientific Division, European Society of Cardiology, EURObservational Research Programme (EORP), 2035 Route des colles, CS 80179 Biot, Sophia-Antipolis Cedex, France. 12. Department of Cardiology, Medical University of Lublin, 20-090 Lublin Str., Jaczewskiego 8, Lublin, Poland. 13. Sahlgrenska University Hospital, Cardiothoracic Surgery, Sahlgrenska/SU, Goteborg, Sweden. 14. Department of Cardiology and Electrotherapy, Medical University of Gdansk, Debinki 7 Str., Gdansk, Poland. 15. Cardiology Department, University Hospital Maggiore della Carità, Corso Mazzini 18, Novara, Italy. 16. Clinique Pasteur, Management of Cardiac Arrhythmias, 45 Avenue de Lombez, Toulouse, France.
Abstract
AIMS: The decision to abandon or extract superfluous leads remains controversial. We sought to compare procedural outcome of patients with and without abandoned leads undergoing transvenous lead extraction (TLE). METHODS AND RESULTS: An analysis of the ESC-EHRA European Lead Extraction ConTRolled ELECTRa registry was conducted. Patients were stratified into two groups based on the presence (Group 1) or absence (Group 2) of abandoned leads at the time for extraction. Out of 3508 TLE procedures, 422 patients (12.0%) had abandoned leads (Group 1). Group 1 patients were older and more likely to have implantable cardioverter-defibrillator devices, infection indication (78.8% vs. 49.8%), and vegetations (24.6% vs. 15.3%). Oldest lead dwelling time was longer in Group 1 (10.9 vs. 6.3 years) as was the number of extracted leads per patient (3.2 vs. 1.7). Manual traction failure (94.5% vs. 78.8%), powered sheath use (50.7% vs. 28.4%), and femoral approach were higher in Group 1 (P < 0.0001). Procedural success rate and clinical success (89.8% vs. 96.6%, P < 0.0001) were lower in Group 1. Major complication including deaths (5.5% vs. 2.3%, P = 0.0007) and procedure related major complications (3.3% vs. 1.4%, P = 0.0123) were higher in Group 1. The presence of abandoned leads at the time of TLE was an independent predictor of clinical failure [odds ratio (OR) 2.31, confidence interval (CI) 1.57-3.40] and complications [OR 1.69, CI 1.22-2.35]. receiver-operating characteristic curve analysis showed a dwell time threshold of 9 years for radiological failure and major complications. CONCLUSIONS: Previously abandoned leads at the time of TLE were associated with increased procedural complexity, clinical failure, and major complication, which may have important implications for future studies regarding managing of lead failures. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The decision to abandon or extract superfluous leads remains controversial. We sought to compare procedural outcome of patients with and without abandoned leads undergoing transvenous lead extraction (TLE). METHODS AND RESULTS: An analysis of the ESC-EHRA European Lead Extraction ConTRolled ELECTRa registry was conducted. Patients were stratified into two groups based on the presence (Group 1) or absence (Group 2) of abandoned leads at the time for extraction. Out of 3508 TLE procedures, 422 patients (12.0%) had abandoned leads (Group 1). Group 1 patients were older and more likely to have implantable cardioverter-defibrillator devices, infection indication (78.8% vs. 49.8%), and vegetations (24.6% vs. 15.3%). Oldest lead dwelling time was longer in Group 1 (10.9 vs. 6.3 years) as was the number of extracted leads per patient (3.2 vs. 1.7). Manual traction failure (94.5% vs. 78.8%), powered sheath use (50.7% vs. 28.4%), and femoral approach were higher in Group 1 (P < 0.0001). Procedural success rate and clinical success (89.8% vs. 96.6%, P < 0.0001) were lower in Group 1. Major complication including deaths (5.5% vs. 2.3%, P = 0.0007) and procedure related major complications (3.3% vs. 1.4%, P = 0.0123) were higher in Group 1. The presence of abandoned leads at the time of TLE was an independent predictor of clinical failure [odds ratio (OR) 2.31, confidence interval (CI) 1.57-3.40] and complications [OR 1.69, CI 1.22-2.35]. receiver-operating characteristic curve analysis showed a dwell time threshold of 9 years for radiological failure and major complications. CONCLUSIONS: Previously abandoned leads at the time of TLE were associated with increased procedural complexity, clinical failure, and major complication, which may have important implications for future studies regarding managing of lead failures. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Dorota Nowosielecka; Wojciech Jacheć; Anna Polewczyk; Andrzej Kleinrok; Łukasz Tułecki; Andrzej Kutarski Journal: Cardiovasc Diagn Ther Date: 2021-04
Authors: Dorota Nowosielecka; Wojciech Jacheć; Anna Polewczyk; Łukasz Tułecki; Andrzej Kleinrok; Andrzej Kutarski Journal: Int J Environ Res Public Health Date: 2021-02-14 Impact factor: 3.390
Authors: David Zweiker; Basma El Sawaf; Giuseppe D'Angelo; Andrea Radinovic; Alessandra Marzi; Luca R Limite; Antonio Frontera; Gabriele Paglino; Michael Spartalis; Donah Zachariah; Kenzaburo Nakajima; Paolo Della Bella; Patrizio Mazzone Journal: J Clin Med Date: 2022-08-19 Impact factor: 4.964