Transvenous extraction of very old (over 20-year-old) pacemaker leads using mechanical systems: Effectiveness and safety

Ząbek, Andrzej, Boczar, Krzysztof, Dębski, Maciej ORCID: https://orcid.org/0000-0002-3669-3916, Matusik, Paweł T., Pfitzner, Roman, Ulman, Mateusz, Musiał, Robert, Lelakowski, Jacek and Małecka, Barbara (2019) Transvenous extraction of very old (over 20-year-old) pacemaker leads using mechanical systems: Effectiveness and safety. Pacing and Clinical Electrophysiology, 42 (7). pp. 998-1005. ISSN 0147-8389

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Abstract

Objective: To analyze and compare the effectiveness and safety of transvenous lead extraction (TLE) with mechanical systems of pacing leads older than 20 years (group A) versus younger leads (group B).   Methods: We performed TLE of 591 pacing leads in 377 patients. Fifty (8.5%) leads in 43 (11.4%) patients were implanted for equal to or more than 20 years. The mean dwell time of all extracted leads was 8.9 years (range, 0.1–36.0). Infection related to cardiovascular implantable electronic device was an indication for TLE in 18.3% of patients.   Results: Complete lead removal and complete procedural success rates were similar between both groups (94.7% in group A vs 97.1% in group B, P = 0.445, and 90.7% in group A vs 95.8% in group B, P = 0.329, respectively). Incomplete lead removal in group A was observed only in leads older than 20 years. Removal of leads in group A was associated with significantly longer fluoroscopy time compared with group B (4.6 vs 1.9 minutes, P < 0.001). We did not find a significant difference in major and minor complication rates between groups (2.3% in group A vs 0.9% in group B and 2.3% in group A vs 2.2% in group B, P = 0.687, respectively). There were no deaths associated with the TLE procedure within 30 days after the procedure in either group.   Conclusion: This study shows that TLE of leads older than 20 years conducted at an experienced center seems to be comparably safe and effective as extraction of younger leads but requires longer fluoroscopy time.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 24 Jan 2023 18:30
Last Modified: 23 May 2024 14:31
URI: https://ueaeprints.uea.ac.uk/id/eprint/90776
DOI: 10.1111/pace.13714

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