Baldeep S Sidhu1,2, Salma Ayis3, Justin Gould1,2, Mark K Elliott1,2, Vishal Mehta1,2, Charles Kennergren4, Christian Butter5, Jean-Claude Deharo6, Andrzej Kutarski7, Aldo P Maggioni8,9, Angelo Auricchio10, Karl-Heinz Kuck11, Carina Blomström-Lundqvist12, Maria Grazia Bongiorni13, Christopher A Rinaldi1,2. 1. School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas' Hospital, London SE1 7EH, UK. 2. Cardiology Department, Guy's and St Thomas' Hospital, London, UK. 3. School of Population Health and Environmental Sciences, King's College London, London, UK. 4. Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Sahlgrenska/SU, 41345 Goteborg, Sweden. 5. Department of Cardiology, Heart Center Brandenburg in Bernau/Berlin & Brandenburg Medical School, Ladeburger Straße 17, 16321 Bernau, Germany. 6. Department of Cardiology, CHU La Timone, Cardiologie, Service du prof Deharo, 264 Rue Saint Pierre, 13385 Marseille, France. 7. Department of Cardiology, Medical University of Lublin, Jaczewskiego Street Nr 8, 20-090 Lublin, Poland. 8. European Society of Cardiology, EORP, 2035 route des Colles, Biot, Sophia Antipolis, France. 9. Maria Cecilia Hospital, GVM Care and Research, Cotignola, Italy. 10. Division of Cardiology, Fondazione Cardiocentro Ticino, Via Tesserete 48, 6900 Lugano, Switzerland. 11. Department of Cardiology, Asklepios Klinik St. Georg, Lohmühlenstraße 5, D-20099 Hamburg, Germany. 12. Department of Medical Science and Cardiology, Uppsala University, Uppsala, Sweden. 13. Cardiology Department, Direttore UO Cardiologia 2 SSN, Azienda Ospedaliero-Universitaria, Pisa, Italy.
Abstract
AIMS: Transvenous lead extraction is associated with a significant risk of complications and identifying patients at highest risk pre-procedurally will enable interventions to be planned accordingly. We developed the ELECTRa Registry Outcome Score (EROS) and applied it to the ELECTRa registry to determine if it could appropriately risk-stratify patients. METHODS AND RESULTS: EROS was devised to risk-stratify patients into low risk (EROS 1), intermediate risk (EROS 2), and high risk (EROS 3). This was applied to the ESC EORP European Lead Extraction ConTRolled ELECTRa registry; 57.5% EROS 1, 31.8% EROS 2, and 10.7% EROS 3. Patients with EROS 3 or 2 were significantly more likely to require powered sheaths and a femoral approach to complete procedures. Patients with EROS 3 were more likely to suffer procedure-related major complications including deaths (5.1 vs. 1.3%; P < 0.0001), both intra-procedural (3.5 vs. 0.8%; P = 0.0001) and post-procedural (1.6 vs. 0.5%; P = 0.0192). They were more likely to suffer post-procedural deaths (0.8 vs. 0.2%; P 0.0449), cardiac avulsion or tear (3.8 vs. 0.5%; P < 0.0001), and cardiovascular lesions requiring pericardiocentesis, chest tube, or surgical repair (4.6 vs. 1.0%; P < 0.0001). EROS 3 was associated with procedure-related major complications including deaths [odds ratio (OR) 3.333, 95% confidence interval (CI) 1.879-5.914; P < 0.0001] and all-cause in-hospital major complications including deaths (OR 2.339, 95% CI 1.439-3.803; P = 0.0006). CONCLUSION: EROS successfully identified patients who were at increased risk of significant procedural complications that require urgent surgical intervention. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Transvenous lead extraction is associated with a significant risk of complications and identifying patients at highest risk pre-procedurally will enable interventions to be planned accordingly. We developed the ELECTRa Registry Outcome Score (EROS) and applied it to the ELECTRa registry to determine if it could appropriately risk-stratify patients. METHODS AND RESULTS: EROS was devised to risk-stratify patients into low risk (EROS 1), intermediate risk (EROS 2), and high risk (EROS 3). This was applied to the ESC EORP European Lead Extraction ConTRolled ELECTRa registry; 57.5% EROS 1, 31.8% EROS 2, and 10.7% EROS 3. Patients with EROS 3 or 2 were significantly more likely to require powered sheaths and a femoral approach to complete procedures. Patients with EROS 3 were more likely to suffer procedure-related major complications including deaths (5.1 vs. 1.3%; P < 0.0001), both intra-procedural (3.5 vs. 0.8%; P = 0.0001) and post-procedural (1.6 vs. 0.5%; P = 0.0192). They were more likely to suffer post-procedural deaths (0.8 vs. 0.2%; P 0.0449), cardiac avulsion or tear (3.8 vs. 0.5%; P < 0.0001), and cardiovascular lesions requiring pericardiocentesis, chest tube, or surgical repair (4.6 vs. 1.0%; P < 0.0001). EROS 3 was associated with procedure-related major complications including deaths [odds ratio (OR) 3.333, 95% confidence interval (CI) 1.879-5.914; P < 0.0001] and all-cause in-hospital major complications including deaths (OR 2.339, 95% CI 1.439-3.803; P = 0.0006). CONCLUSION: EROS successfully identified patients who were at increased risk of significant procedural complications that require urgent surgical intervention. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Andrzej Kutarski; Wojciech Jacheć; Łukasz Tułecki; Marek Czajkowski; Dorota Nowosielecka; Paweł Stefańczyk; Konrad Tomków; Anna Polewczyk Journal: Sci Rep Date: 2022-06-10 Impact factor: 4.996
Authors: Łukasz Tułecki; Anna Polewczyk; Wojciech Jacheć; Dorota Nowosielecka; Konrad Tomków; Paweł Stefańczyk; Jarosław Kosior; Krzysztof Duda; Maciej Polewczyk; Andrzej Kutarski Journal: Int J Environ Res Public Health Date: 2021-08-28 Impact factor: 3.390
Authors: Anna Polewczyk; Wojciech Jacheć; Dorota Nowosielecka; Andrzej Tomaszewski; Wojciech Brzozowski; Dorota Szczęśniak-Stańczyk; Krzysztof Duda; Andrzej Kutarski Journal: Int J Environ Res Public Health Date: 2022-09-27 Impact factor: 4.614