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. 2018 Dec 18:2018:8796704.
doi: 10.1155/2018/8796704. eCollection 2018.

Risk Factors Predicting Complications of Transvenous Lead Extraction

Wojciech Jacheć  1 , Anna Polewczyk  2   3 , Maciej Polewczyk  2   4 , Andrzej Tomasik  1 , Marianna Janion  2   3 , Andrzej Kutarski  5
Affiliations

Risk Factors Predicting Complications of Transvenous Lead Extraction

Wojciech Jacheć et al. Biomed Res Int. .

Abstract

Objective: Transvenous lead extraction (TLE) is the gold standard in the management of patients with cardiac implantable electronic devices (CIED)-related complications. Knowledge of TLE risk factors is very important.

Methods: Clinical data from 1915 patients undergoing TLE at the Reference Center between 2006 and 2015 were analyzed. The effects of clinical and procedure-related factors on the development of major (MJC) and minor (MIC) complications and survival after TLE were evaluated.

Results: MJC were caused mainly by lead implant duration, presence of abandoned leads, multiple procedures preceding TLE, and any technical problem during TLE. Of clinical factors female gender and anemia increased the risk of MJC. MIC were reported in patients with the first implantation of CIED under the age of 30 and after sternotomy analysis of 30-day survival after procedure demonstrated a significant effect of clinical factors and lead dwell times, previous unsuccessful TLE, and MIC.

Conclusions: Efficacy and safety of TLE depend mainly on procedure-related factors. This knowledge is essential for preventing MJC and MIC. Mortality at 30 days following TLE is mainly associated with the clinical factors; however, there was also a significant effect of lead dwell time and periprocedural complications on the short-term prognosis of patients undergoing TLE.

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Figures

Figure 1
Figure 1
Risk factors of death in 30-day follow-up, results of multivariate stepwise Cox regression.
Figure 2
Figure 2
Kaplan–Meier death-free survival probability in 30-day follow-up depending on (a) failure of clinical success of TLE, (b) indications for TLE (infective versus noninfective), (c) NYHA class before TLE (I,II versus III, IV), and (d) previous unsuccessful attempt to TLE.
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