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Risk score to assess mortality risk in patients undergoing transvenous lead extraction
Author(s) -
Oszczygieł Ewa,
Kutarski Andrzej,
Oszczygieł Andrzej,
MańkowskaZałuska Beata,
Chudzik Michał,
Wranicz Jerzy Krzysztof,
Cygankiewicz Iwona
Publication year - 2017
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13127
Subject(s) - medicine , infective endocarditis , retrospective cohort study , mortality rate , surgery , heart failure , cohort , single center , implantable cardioverter defibrillator , population , cardiology , environmental health
Aims The main aim of this study was to assess 1‐year mortality and its predictors in a cohort of patients who underwent transvenous lead extraction (TLE) procedure. Methods Retrospective analysis of clinical characteristics and 1‐year follow‐up of patients referred for a TLE procedure in a single, high‐volume center between June 2006 and October 2014 was performed. Results The studied population included 130 patients (82 males; mean age 64 ± 15 years) implanted with pacemakers (74%), implantable cardioverter defibrillators (15%), or cardiac resynchronization therapy defibrillator (11%). Indications for the extraction included infective endocarditis (40.5%), pocket infection (18.5%), and lead fault or failure (41%). Total radiological success rate was 90% while clinical success rate was 93.5%. The cumulative 1‐year mortality was 28%. Mortality was higher in a group of older patients (94.4% vs 68%, P = 0.001) and those with chronic kidney disease (33.3% vs 4.3 %, P = 0.0002) as well as in patients after removal of high voltage lead (88.9% vs 26.3%, P = 0.01). Higher mortality was also related to infection as an indication for TLE (37.2% vs 13.5%, P = 0.002). Following these findings a new risk score model named IKAR (I = infective indications; K = kidney dysfunction; A = age ≥ 56; R = removal of high voltage lead) was constructed. Patients with IKAR score ≥3 points were characterized by 79% mortality as compared to 16% in those with a score 1–2 points. Conclusions One‐year mortality of patients undergoing TLE procedure can be predicted by using IKAR risk score.