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Long-term mortality after transvenous lead extraction.

Melanie Maytin1, Samuel O Jones, Laurence M Epstein

  • 1Brigham and Women's Hospital, Boston, MA 02115, USA. mmaytin@partners.org

Circulation. Arrhythmia and Electrophysiology
|February 25, 2012
PubMed
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Transvenous lead extraction (TLE) has low procedural mortality but high long-term mortality, especially for elderly patients or those with infections. Understanding these risks aids cardiovascular implantable electronic device management.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Increasing use of cardiovascular implantable electronic devices necessitates more transvenous lead extractions (TLE).
  • Limited data exists on postprocedural and long-term mortality following TLE procedures.

Purpose of the Study:

  • To analyze postprocedural and long-term mortality after TLE.
  • To identify factors associated with mortality in patients undergoing TLE.

Main Methods:

  • Retrospective analysis of 985 patients undergoing 1043 TLE procedures from 2000-2010.
  • Multivariable Cox regression model to determine mortality predictors.
  • Kaplan-Meier analysis for survival rates over time.

Main Results:

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  • No procedure-related deaths occurred.
  • 10-year cumulative mortality reached 46.8%.
  • Significant mortality risk factors included systemic infection, local infection, device system upgrade, diabetes, increasing age, and elevated serum creatinine.

Conclusions:

  • While TLE procedural mortality is low, long-term survival is concerning for specific patient groups.
  • Elderly patients and those with infectious indications or undergoing device system upgrades face higher mortality risks.
  • Long-term outcome data is crucial for managing cardiovascular implantable electronic devices and leads.