In-Hospital and Midterm Outcomes of Lead Extraction: A Single-Center Clinical Study
Fahimeh Valizadeh-Shiran1,2, Negin Sadat Hosseini Mohammadi1,2, Kiarash Tavakoli1,2
1Department of Cardiac Electrophysiology, Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Lead extraction for cardiovascular implantable electronic devices is highly successful, with a 90.2% success rate. This procedure demonstrates a low incidence of in-hospital death and complications, making it a safe option.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Procedures
Background:
- Increasing use of cardiovascular implantable electronic devices (CIEDs) has led to a rise in lead extraction procedures.
- Limited data exists on the safety and complications associated with CIED lead extraction.
- This study aimed to evaluate in-hospital and midterm outcomes of lead extraction.
Purpose of the Study:
- To assess the procedural success rate of lead extraction.
- To investigate in-hospital and midterm complications related to lead extraction.
- To evaluate the safety profile of lead extraction procedures.
Main Methods:
- Retrospective analysis of 51 patients undergoing lead extraction at Tehran Heart Center (2016-2021).
- Data collected included demographic characteristics, procedural success, and in-hospital/midterm complications.
- Focus on pacemaker/defibrillator lead extraction.
Main Results:
- A total of 109 leads were extracted from 51 patients, with a 90.2% complete procedural success rate.
- In-hospital mortality was 7.8% (4 patients), with causes including pneumonia and septic shock.
- Procedure-related adverse events occurred in 5.8% of patients (lung laceration, subclavian injury, tamponade).
Conclusions:
- Lead extraction is a highly successful procedure.
- The rate of death-related events and complications is low.
- The study supports the safety and efficacy of lead extraction in managing CIEDs.
Background:
The rate of lead extraction has steadily increased alongside the extensive use of cardiovascular implantable electronic devices. Data on the complications and safety of this challenging procedure are limited. We investigated inhospital and midterm outcomes following lead extraction.
Methods:
Data were retrieved from 51 patients who underwent pacemaker/defibrillator lead extraction procedures at Tehran Heart Center between 2016 and 2021. The procedural success rate, patients' demographic characteristics, and inhospital and midterm procedure-related complications were investigated.
Results:
Fifty-one patients were enrolled, including 44 men (86.3%). A total of 109 leads were extracted, with a 90.2% complete procedural success rate. In-hospital death occurred in 4 patients (7.8%): 1 patient (1.9%) died from pneumonia, 1 (1.9%) from septic shock, and 2 (3.9%) from septic shock besides heparin-induced thrombocytopenia. Adverse events in 3 patients (5.8%) were directly related to the procedure: 1 patient (1.9%) suffered lung laceration and hemorrhage, 1 (1.9%) sustained subclavian injury, and 1 (1.9%) developed tamponade. Neither reinfection nor rehospitalization was observed during follow-up.
Conclusion:
Lead extraction can be considered a highly successful procedure with a low rate of death-related events and complications.
