Author + information
- Dilek Yilmaz,
- Martin Schalij,
- Lieselot van Erven and
- Rinske Bakker
Background: The number of transvenous lead extractions increased significantly as a result of increasing device implantation rates as well as increasing patient life expectancy. The aim of this study was to compare results of lead removal procedures in the period from 2010 to 2015 with the results obtained from 2000 to 2009 (as previously published by our group).
Methods: Procedural reports of all patients (n=266 (mean age: 65±15; 78% male) undergoing lead removal at our center between 2010 – 2015 were reviewed. Procedures were reviewed for complexity, indication, success, complication rates and mortality. Complexity was defined as procedures involving older leads, higher number of leads per procedure and need for assistance of more and different extraction tools and for femoral approach. The outcomes were compared with the results of the 2000 to 2009 cohort (n=279 (mean age 61±16; 77% male). The primary outcomes of interest were complete removal success, clinical success and complications.
Results: A total of 266 procedures involving 578 leads from 2010 to 2015 were compared to 279 procedures (445 leads) from 2000-2009. Type of removed leads evolved to more ICD/CRT-D related leads and less RV pacing leads (p<0.001). Complexity was higher in the contemporary cohort with the median dwell time of leads increasing from 2.6 years to 5.3 years and a larger number of leads removed per procedure (2.6±1.1 (2010-2015) vs. 1.6±0.7 (2000-2009)). Complete removal achieved without the use of non-powered extraction tools from the pectoral area decreased from 85% to 67% (p<0.001). A femoral approach was required in 126 (22%) cases in the contemporary vs. 50 (11%) in the early cohort (p<0.001). Clinical success however was comparable (95% vs. 97%, NS). Procedure-related mortality and overall complication rate were similar (0% vs. 0.8% and 5.4% vs. 6,8%, respectively.).
Conclusions: Even though lead extractions have become more complex (i.e. longer dwell time, higher number of leads per procedure, need for advanced extraction tools and femoral approach), clinical success rate remained similar over time.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias and Clinical EP: Devices 4
Abstract Category: 5. Arrhythmias and Clinical EP: Devices
Presentation Number: 1278-080
- 2017 American College of Cardiology Foundation