Long-Term Outcomes Following Transvenous Lead Extraction

Area of Science:

• Cardiology
• Medical Devices
• Interventional Cardiology

Background:

• Complications from cardiac implantable electronic devices often necessitate transvenous lead extraction (TLE).
• Long-term outcomes of TLE, including mortality and infection, require further investigation.

Purpose of the Study:

• To report the long-term follow-up of patients undergoing transvenous lead extraction (TLE).
• To assess mortality, recurrent device infection, and the need for repeat procedures after TLE.

Main Methods:

• A retrospective analysis of consecutive patients undergoing TLE at a high-volume center.
• Evaluation of patient characteristics, indications for TLE, and procedural outcomes.
• Long-term follow-up assessing mortality, infection rates, and repeat procedures.

Main Results:

• 1,006 leads were extracted from 510 patients with a 98.2% clinical success rate.
• Long-term mortality reached 33.0% at 10 years, significantly associated with cardiac device infection, procedural complications, advanced age, and renal impairment.
• The rate of cardiac device infection post-TLE was 3.9%, higher in patients with retained lead fragments (13.5%).

Conclusions:

• Long-term mortality after TLE is substantial, particularly for patients with systemic infection, procedural complications, advanced age, and renal impairment.
• Retained lead fragments post-extraction are a significant risk factor for subsequent cardiac device infection.