Clinical Effectiveness and Safety of Transvenous Lead Extraction of Very Old Leads.

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Heart rhythm Pub Date : 2024-11-20 DOI:10.1016/j.hrthm.2024.11.022

Wissam Mekary, Neal K Bhatia, Stacy Westerman, Anand Shah, Faisal M Merchant, Mikhael F El-Chami

{"title":"Clinical Effectiveness and Safety of Transvenous Lead Extraction of Very Old Leads.","authors":"Wissam Mekary, Neal K Bhatia, Stacy Westerman, Anand Shah, Faisal M Merchant, Mikhael F El-Chami","doi":"10.1016/j.hrthm.2024.11.022","DOIUrl":null,"url":null,"abstract":"Background: Transvenous Lead extraction (TLE) success and safety are heavily influenced by lead dwell time.Objective: In this study, we aim to compare the clinical effectiveness and safety of transvenous lead extraction between young and old leads.Methods: We retrospectively identified all TLE procedures at Emory Healthcare from 2007-2023. Baseline patients' characteristics and procedural details were collected. The cohort was categorized based on the oldest lead dwell time in each procedure. The very long-dwell time (VLDT) group included all procedures with the oldest lead dwell time ≥15 years, whereas the control group included all procedures with the oldest lead dwell time <15 years. TLE outcomes were compared between the 2 groups.Results: Of the 1717 TLE procedures, 114 procedures (6.6%) included leads with dwell times ≥15 years. Patients in the VLDT group were older and had a higher number of targeted leads. 57% of TLE in the VLDT group were for infectious indications. Lead extraction procedural and clinical success were significantly lower in the VLDT group compared to the control group (75% vs 95%, 83% vs 97%, p<0.001, respectively). There was a trend towards a higher major complications rate in the VLDT group compared to the control group (3.5% vs 1.3%, p=0.058).Conclusion: TLE of VLDT leads has a lower procedural and clinical success and a higher complication rate than TLE of leads with a shorter dwell time. These results will allow electrophysiologists to quantify risks and benefits of abandoning leads at the time of lead revisions or upgrades.","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":" ","pages":""},"PeriodicalIF":5.6000,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart rhythm","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.hrthm.2024.11.022","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Transvenous Lead extraction (TLE) success and safety are heavily influenced by lead dwell time.

Objective: In this study, we aim to compare the clinical effectiveness and safety of transvenous lead extraction between young and old leads.

Methods: We retrospectively identified all TLE procedures at Emory Healthcare from 2007-2023. Baseline patients' characteristics and procedural details were collected. The cohort was categorized based on the oldest lead dwell time in each procedure. The very long-dwell time (VLDT) group included all procedures with the oldest lead dwell time ≥15 years, whereas the control group included all procedures with the oldest lead dwell time <15 years. TLE outcomes were compared between the 2 groups.

Results: Of the 1717 TLE procedures, 114 procedures (6.6%) included leads with dwell times ≥15 years. Patients in the VLDT group were older and had a higher number of targeted leads. 57% of TLE in the VLDT group were for infectious indications. Lead extraction procedural and clinical success were significantly lower in the VLDT group compared to the control group (75% vs 95%, 83% vs 97%, p<0.001, respectively). There was a trend towards a higher major complications rate in the VLDT group compared to the control group (3.5% vs 1.3%, p=0.058).

Conclusion: TLE of VLDT leads has a lower procedural and clinical success and a higher complication rate than TLE of leads with a shorter dwell time. These results will allow electrophysiologists to quantify risks and benefits of abandoning leads at the time of lead revisions or upgrades.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

经静脉抽取老化铅的临床有效性和安全性。

背景：经静脉导联取出术（TLE）的成功率和安全性在很大程度上受导联停留时间的影响：在本研究中，我们旨在比较新旧导联经静脉导联取出的临床有效性和安全性：我们回顾性地确定了 2007-2023 年埃默里医疗保健中心的所有 TLE 手术。我们收集了患者的基线特征和手术细节。根据每次手术中最长的导联停留时间对队列进行分类。超长导联停留时间（VLDT）组包括所有最长导联停留时间≥15 年的手术，而对照组包括所有最长导联停留时间≥15 年的手术：在1717例TLE手术中，有114例手术（6.6%）的导联停留时间≥15年。VLDT 组患者年龄较大，目标导联数量较多。VLDT 组中 57% 的 TLE 为感染性适应症。与对照组相比，VLDT 组的导联拔出手术成功率和临床成功率明显较低（75% 对 95%，83% 对 97%，p 结论：VLDT 导联的 TLE 与停留时间较短的导联 TLE 相比，手术和临床成功率较低，并发症发生率较高。这些结果将有助于电生理学家量化在导联翻新或升级时放弃导联的风险和益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.