Analysis of electrical lead failures in patients referred for transvenous lead extraction procedures

Ząbek, Andrzej; Boczar, Krzysztof; Dębski, Maciej; Ulman, Mateusz; Matusik, Paweł T.; Lelakowski, Jacek; Małecka, Barbara

doi:10.1111/pace.13463

Cited by 6 publications

(11 citation statements)

References 23 publications

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“…In our study cohort, noninfectious indications were present in 81.7% of the patients. The observed low rate of TLE due to infection results from our strategy to rigorously treat pacing‐related complications and is consistent with our previous reports . The qualification for the TLE procedure was based on careful consideration with the patient whether to abandon or remove a lead and/or CIED .…”

Section: Discussionsupporting

confidence: 87%

“…The observed low rate of TLE due to infection results from our strategy to rigorously treat pacing‐related complications and is consistent with our previous reports . The qualification for the TLE procedure was based on careful consideration with the patient whether to abandon or remove a lead and/or CIED . This process has been in line with the current expert consensus statement .…”

Section: Discussionsupporting

confidence: 85%

“…The increasing use of cardiovascular implantable electronic devices (CIEDs) in patients with cardiac rhythm disorders has led to prolongation of patient survival and/or improved quality of life. On the other hand, the increasing number of CIEDs has been associated with a higher prevalence of CIED‐related complications …”

Section: Introductionmentioning

confidence: 99%

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Transvenous extraction of very old (over 20‐year‐old) pacemaker leads using mechanical systems: Effectiveness and safety

Ząbek

Boczar

Dębski

et al. 2019

Pacing Clinical Electrophis

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Objective:To analyze and compare the effectiveness and safety of transvenous lead extraction (TLE) with mechanical systems of pacing leads older than 20 years (group A) versus younger leads (group B). Methods:We performed TLE of 591 pacing leads in 377 patients. Fifty (8.5%) leads in 43 (11.4%) patients were implanted for equal to or more than 20 years. The mean dwell time of all extracted leads was 8.9 years (range, 0.1-36.0). Infection related to cardiovascular implantable electronic device was an indication for TLE in 18.3% of patients. Results:Complete lead removal and complete procedural success rates were similar between both groups (94.7% in group A vs 97.1% in group B, P = 0.445, and 90.7% in group A vs 95.8% in group B, P = 0.329, respectively). Incomplete lead removal in group A was observed only in leads older than 20 years. Removal of leads in group A was associated with significantly longer fluoroscopy time compared with group B (4.6 vs 1.9 minutes, P < 0.001). We did not find a significant difference in major and minor complication rates between groups (2.3% in group A vs 0.9% in group B and 2.3% in group A vs 2.2% in group B, P = 0.687, respectively). There were no deaths associated with the TLE procedure within 30 days after the procedure in either group. Conclusion:This study shows that TLE of leads older than 20 years conducted at an experienced center seems to be comparably safe and effective as extraction of younger leads but requires longer fluoroscopy time. K E Y W O R D Scardiovascular implantable electronic devices, effectiveness, safety, transvenous lead extraction

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 85%

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Transvenous extraction of very old (over 20‐year‐old) pacemaker leads using mechanical systems: Effectiveness and safety

Ząbek

Boczar

Dębski

et al. 2019

Pacing Clinical Electrophis

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“…The observed low rate of TLE due to infection results from our strategy to rigorously treat pacing -related adverse events and is consistent with our previous report. 16 The decision whether or not to perform TLE was based on significant predictors of 30 -day mortality. In the multivariable analysis, only lower hemoglobin levels (OR, 1.642 per 1 g/dl), higher CCI (OR, 1.836 per 1 point), and the number of extracted leads at the index procedure (OR, 3.441 per 1 lead) remained significant.…”

Section: What's New?mentioning

confidence: 99%

Indications, procedural and early results of transvenous lead extraction in elderly patients: single-centre experience

Ząbek¹,

Boczar²,

Dębski³

et al. 2020

Polish Archives of Internal Medicine

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“…[3,4] Importantly, ICD leads are prone to damage in long-term follow-up. [5,6] Kleemann et al demonstrated an increasing annual rate of failure among ICD leads during long-term follow-up, which reached 20% in 10-year-old ICD leads. [7] Increasing number of ICD lead implantations and significant risk of lead failure have resulted in growing need for TLE procedures involving ICD leads.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of transvenous extraction of single- versus dual-coil implantable cardioverter-defibrillator leads at single-center experience

Ząbek¹,

Boczar²,

Dębski³

et al. 2019

Medicine

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The available literature lacks data concerning direct comparison of the effectiveness and safety of single- versus dual-coil implantable cardioverter-defibrillator (ICD) leads transvenous extraction. Certainly, additional shocking coil in superior vena cava adds to the amount of metal in the vascular system. Adhesions developing around the superior vena cava coil add to the difficulty of extraction of ICD lead if lead removal is required. The aim of the study was to assess the effectiveness and safety of single- and dual-coil ICD leads transvenous extraction using mechanical systems. We performed transvenous lead extraction (TLE) of 197 ICD leads in 196 patients. There were 46 (23.3%) dual-coil leads removed from 46 (23.5%) patients. Cardiovascular implantable electronic device-related infection was an indication for TLE in 25.0% of patients. The following extracting techniques were used: manual direct traction, mechanical telescopic sheaths, controlled-rotation mechanical sheaths, and femoral approach. Complete ICD lead removal and complete procedural success in both groups were similar (99.3% in single-coil vs 97.8% in dual-coil, P = .41 and 99.3% in single-coil vs 97.8% in dual-coil, P = 0.41, respectively). We did not find significant difference between major and minor complication rates in both groups (2.0% in single-coil vs 4.3% in dual-coil, and 0.7% in single-coil vs 0.0% in dual-coil, P = .58, respectively). There was 1 death associated with the TLE procedure of single-coil lead. This study shows that extraction of dual-coil leads seems to be comparably safe and effective to extraction of single-coil leads. On the other hand, it requires longer fluoroscopy time and frequent utilization of advanced tools.

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Analysis of electrical lead failures in patients referred for transvenous lead extraction procedures

Abstract: The most significant factors predisposing patients to ELF are the lead implantation approach and the presence of a cardioverter-defibrillator lead.

Cited by 6 publications

References 23 publications

Transvenous extraction of very old (over 20‐year‐old) pacemaker leads using mechanical systems: Effectiveness and safety

Transvenous extraction of very old (over 20‐year‐old) pacemaker leads using mechanical systems: Effectiveness and safety

Indications, procedural and early results of transvenous lead extraction in elderly patients: single-centre experience

Effectiveness and safety of transvenous extraction of single- versus dual-coil implantable cardioverter-defibrillator leads at single-center experience

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