Author + information
- Michael P. Brunner,
- Changhong Yu,
- Rory Hachamovitch,
- Valeria Duarte,
- Edmond M. Cronin,
- Bryan Baranowski,
- Khaldoun G. Tarakji,
- Daniel J. Cantillon,
- David O. Martin,
- Oussama Wazni and
- Bruce L. Wilkoff
Although risk factors for major adverse events (MAE) and 30-day all-cause mortality in patients undergoing transvenous lead extraction (TLE) are known, the cumulative risk rendered by their combination has not been determined. Our objective was to create a preoperative risk score for determining TLE outcomes.
3000 TLE procedures were performed and 5533 leads were extracted at the Cleveland Clinic between August 1996 and August 2011. Integer risk scores for MAE and 30-day all-cause mortality were developed from a multivariable regression model using baseline clinical and procedural characteristics.
MAE occurred in 45 (1.5%) patients and had 4 independent baseline predictors (age, platelet count, combined age of leads, and end-stage renal disease [ESRD]) (model c-statistic = 0.636). 30-day all-cause mortality occurred in 61 (2.0%) patients and had 8 independent baseline predictors (age, body mass index [BMI], platelet count, international normalized ratio [INR], ESRD, New York Heart Association [NYHA] functional class, valvular heart disease, and indication for lead extraction) (model c-statistic = 0.832). The figure includes integer risk score nomograms (A, C) and calibration plots (B, D) for MAE and 30-day all-cause mortality, respectively.
Risk of MAE & 30-day all-cause mortality in particular can be assessed with good discriminative power using readily available clinical information. Further prospective validation of the models is anticipated.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmias: Devices I – Identification and Avoidance of Complications Associated with Implantable Devices
Abstract Category: 8. Arrhythmias: Devices
Presentation Number: 1149-28
- 2013 American College of Cardiology Foundation