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Transvenous extraction of very old (over 20‐year‐old) pacemaker leads using mechanical systems: Effectiveness and safety
Author(s) -
Ząbek Andrzej,
Boczar Krzysztof,
Dębski Maciej,
Matusik Paweł T.,
Pfitzner Roman,
Ulman Mateusz,
Musiał Robert,
Lelakowski Jacek,
Małecka Barbara
Publication year - 2019
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.13714
Subject(s) - medicine , lead (geology) , group b , complication , group a , fluoroscopy , surgery , significant difference , confidence interval , geomorphology , geology
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.