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Published on: August 15, 2025
Procedural outcomes and long-term survival following lead extraction in octogenarians
Mikhael F El-Chami1, Michael N Sayegh2, Adarsh Patel3
1Division of Cardiology-Section of Electrophysiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Background:
Octogenarians account for a significant percentage of patients with indwelling pacemakers or defibrillators.
Objectives:
To determine procedural outcomes and long-term survival after lead extraction (LE) in octogenarians.
Methods:
We retrospectively identified all patients who underwent defibrillator or pacemaker LE at our institution between January 1, 2007 and May 31, 2016. Patients were stratified based on age into two groups: <80 years old (Group 1, n = 674) or ≥80 (Group 2, n = 100). Outcomes were determined by medical records review and query of the Social Security Death Index.
Results:
Patients in Group 2 were more likely to be hypertensive (77% vs 61%, P = 0.02), more like to have coronary artery disease (50% vs 39%, P = 0.049), and more likely to be extracted for infectious indications (47% vs 33%, P = .009). The number of leads extracted per procedure was 2.0 ± 0.8 and the mean dwell time of the oldest extracted lead was 5.6 ± 4.3 years, without significant differences between groups. Extraction procedure success (Group 1: 94.7%, Group 2: 96%, P = 0.808) and procedural deaths (Group 1: 0.9% vs Group 2: 0%, P = 1.0) were similar. There was no significant difference in survival up to 3 years following LE between groups.
Conclusion:
At experienced centers, LE can be performed safely in octogenarians with procedural success rates and long-term survival comparable to younger individuals.
