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The Japanese lead extraction registry (J-LEX): Annual report 2020

Morio Shoda1, Kengo Kusano2, Masahiko Goya3

  • 1Clinical Research Division of Heart Rhythm Management, Department of Cardiology Tokyo Women's Medical University Tokyo Japan.

Journal of Arrhythmia
|July 5, 2022
PubMed

Insights

The Japanese lead extraction registry (J-LEX) reported on 785 transvenous lead extraction (TLE) procedures in 2020. While TLE success rates remain high, a slight increase in perioperative complications was noted compared to 2019.

Area of Science:

  • Cardiology
  • Medical Device Technology
  • Public Health

Background:

  • The Japanese Heart Rhythm Society established the Japanese lead extraction registry (J-LEX) in 2018.
  • J-LEX is a mandatory, multi-center, prospective, observational registry for transvenous lead extraction (TLE).
  • The 2020 report details the second annual data collection from the registry.

Purpose of the Study:

  • To report the findings from the second annual data collection of the Japanese lead extraction registry (J-LEX).
  • To analyze trends in transvenous lead extraction (TLE) procedures, indications, success rates, and complications in Japan.
  • To compare outcomes from 2020 with previous years, considering the impact of the COVID-19 pandemic.

Main Methods:

  • Prospective, observational data collection from 75 hospitals participating in the J-LEX registry.
  • Inclusion of 785 transvenous lead extraction (TLE) cases from 2020.
  • Analysis of patient demographics, procedure settings, TLE indications, lead implantation duration, procedural success, and perioperative complications.

Main Results:

  • TLE procedures were performed on patients with an average age of 71.7 years, predominantly male (72.5%).
  • The primary indication for TLE was infection (62.8%), with most procedures classified as guideline class-I (67.4%) or class-IIa (23.8%).
  • Complete lead removal was achieved in 96.6%, with a clinical success rate of 98.1%. Perioperative complications occurred in 7.1% of patients, with a total of four in-hospital deaths. A slight increase in complications was observed compared to 2019.

Conclusions:

  • The 2020 J-LEX report indicates a growing number of transvenous lead extraction (TLE) procedures in Japan, even during the COVID-19 pandemic.
  • High rates of complete lead removal and clinical success were maintained.
  • A modest increase in perioperative complications warrants continued monitoring and analysis.

Keywords:
complicationimplantable cardioverter defibrillatorlead extractionpacemakerregistry

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