Wojciech Jacheć1, Anna Polewczyk2,3, Luca Segreti4, Maria Grazia Bongiorni4, Andrzej Kutarski5. 1. 2nd Department of Cardiology, Medical University of Silesia, School of Medicine with the Division of Dentistry in Zabrze, Zabrze, Poland. 2. Faculty of Medicine and Health Sciences Kielce, The Jan Kochanowski University, Kielce, Poland. 3. Swietokrzyskie Cardiology Center, Kielce, Poland. 4. Department of Cardiology, University Hospital of Pisa, Pisa, Italy. 5. Department of Cardiology, Medical University, Lublin, Poland.
Abstract
INTRODUCTION: The increasing number of cardiac implantable electronic device complications represents a current problem. Abandoned leads are difficult to manage, even because indications to transvenous lead extraction (TLE) cannot be generalized. The aim of the study was to assess the late consequences of previous abandoned leads. METHODS: We did a retrospective analysis of clinical data from 3,810 patients undergoing TLE in two high-volume centers (Poland and Italy) in the years 2006-2017. In order to evaluate the effects of lead abandonment, the patients were divided into a group of 582 (15.3%) subjects with abandoned leads (AL) and a group of 3,228 (84.7%) subjects with functional leads (FL). RESULTS: Infective indications to TLE were predominant in the AL group (61.34% vs 43.4%; P < 0.001). AL was associated with a higher number of leads per patient, longer lead dwell times, more frequent venous occlusion, higher probability of intracardiac lead abrasion, and tricuspid regurgitation (P < 0.001 for all factors). The presence of AL was connected with more frequent technical complications of TLE (odds ratio [OR] 1.617; confidence interval [CI] 1.412-1.852; P = 0.000), lower procedural success rate (OR 0.270; CI 0.199-0.363; P = 0.000), and with higher mortality rate during 3.518 years of follow-up [hazard ratio 1.286; 95% CI (1.062-1.558), P = 0.010]. CONCLUSIONS: Presence of previously abandoned leads was associated with the risk of device infections, technical problems during subsequent lead extraction, dysfunction of tricuspid valve, and worse long-term outcomes.
INTRODUCTION: The increasing number of cardiac implantable electronic device complications represents a current problem. Abandoned leads are difficult to manage, even because indications to transvenous lead extraction (TLE) cannot be generalized. The aim of the study was to assess the late consequences of previous abandoned leads. METHODS: We did a retrospective analysis of clinical data from 3,810 patients undergoing TLE in two high-volume centers (Poland and Italy) in the years 2006-2017. In order to evaluate the effects of lead abandonment, the patients were divided into a group of 582 (15.3%) subjects with abandoned leads (AL) and a group of 3,228 (84.7%) subjects with functional leads (FL). RESULTS: Infective indications to TLE were predominant in the AL group (61.34% vs 43.4%; P < 0.001). AL was associated with a higher number of leads per patient, longer lead dwell times, more frequent venous occlusion, higher probability of intracardiac lead abrasion, and tricuspid regurgitation (P < 0.001 for all factors). The presence of AL was connected with more frequent technical complications of TLE (odds ratio [OR] 1.617; confidence interval [CI] 1.412-1.852; P = 0.000), lower procedural success rate (OR 0.270; CI 0.199-0.363; P = 0.000), and with higher mortality rate during 3.518 years of follow-up [hazard ratio 1.286; 95% CI (1.062-1.558), P = 0.010]. CONCLUSIONS: Presence of previously abandoned leads was associated with the risk of device infections, technical problems during subsequent lead extraction, dysfunction of tricuspid valve, and worse long-term outcomes.
Authors: Dorota Nowosielecka; Wojciech Jacheć; Anna Polewczyk; Andrzej Kleinrok; Łukasz Tułecki; Andrzej Kutarski Journal: Cardiovasc Diagn Ther Date: 2021-04
Authors: Paweł Stefańczyk; Dorota Nowosielecka; Łukasz Tułecki; Konrad Tomków; Anna Polewczyk; Wojciech Jacheć; Andrzej Kleinrok; Wojciech Borzęcki; Andrzej Kutarski Journal: Vasc Health Risk Manag Date: 2021-08-05