Impact of infective versus sterile transvenous lead removal on 30-day outcomes in cardiac implantable electronic...

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Device Technology

Background:

• Transvenous lead removal (TLR) is a procedure associated with significant risks.
• Evaluating the impact of cardiac implantable electronic device (CIED) infection on TLR outcomes is critical.

Purpose of the Study:

• To assess the in-hospital mortality and adverse outcomes of TLR based on infective versus sterile indications.
• To determine the association between CIED infection and major adverse events following TLR.

Main Methods:

• Utilized the Nationwide Readmissions Database (2017-2020) for a large-scale analysis of patients undergoing TLR.
• Categorized TLR indications as infective (bacteremia, sepsis, endocarditis) or sterile.
• Compared in-hospital mortality and major adverse events between the two TLR indication groups.

Main Results:

• Out of 25,144 TLR patients, 44.2% had device infection indications.
• TLR for infection showed significantly higher in-hospital mortality (5.59% vs 1.13%) and risk of thromboembolic events (OR=3.80).
• No significant difference in conversion to open heart surgery or independent prediction of cardiac/vascular complications.

Conclusions:

• Infective indications for TLR are associated with substantially higher in-hospital mortality and thromboembolic event rates.
• These findings underscore the importance of identifying and treating CIED infections promptly to mitigate risks associated with TLR.