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The GermAn Laser Lead Extraction RegistrY: GALLERY.

Simon Pecha1, Heiko Burger2, Da Un Chung3

  • 1Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, University Hospital Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|June 19, 2022
PubMed
Summary

The German Laser Lead Extraction Registry (GALLERY) found laser lead extraction procedures to be highly successful and safe. Key predictors for complications included female sex and abandoned leads, while infection and age predicted mortality.

Keywords:
CIED infectionImplantable cardioverter-defibrillatorLaser lead extractionLead endocarditisLead extractionPacemaker

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Area of Science:

  • Cardiology
  • Medical Device Technology
  • Public Health

Background:

  • Implantable cardioverter-defibrillators (ICDs) and pacemakers require lead extraction for various reasons.
  • Laser lead extraction is a specialized technique for removing these leads.
  • Data on the safety and efficacy of laser lead extraction in a large, real-world setting are crucial.

Purpose of the Study:

  • To investigate the safety and efficacy of laser lead extraction procedures.
  • To identify predictors for procedural complications and mortality.
  • To assess outcomes in a national multicentre registry.

Main Methods:

  • Retrospective analysis of the German Laser Lead Extraction Registry (GALLERY).
  • Inclusion of 2524 patients undergoing laser lead extraction between January 2013 and March 2017.
  • Data collection on procedural success, complications, and mortality.

Main Results:

  • High clinical procedural success rate (97.86%) and complete lead removal (94.85%).
  • Low overall complication rate (4.32%), with procedure-related mortality at 0.55%.
  • Lead age ≥10 years predicted procedural failure; female sex and abandoned leads predicted complications.

Conclusions:

  • Laser lead extraction demonstrates high efficacy and a favorable safety profile.
  • Identifying patient-specific risk factors is essential for optimizing outcomes.
  • Systemic infection, advanced age, and chronic kidney disease are significant predictors of mortality.