Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct;47(10):1293-1299.
doi: 10.1111/pace.15062. Epub 2024 Aug 19.

Outcome of transvenous lead extraction in nonagenarians: A single-center retrospective study

Toshinori Komatsu  1 , Ayako Okada  1 , Morio Shoda  1   2 , Kiu Tanaka  1 , Hideki Kobayashi  1 , Yasutaka Oguchi  1 , Tatsuya Saigusa  1 , Soichiro Ebisawa  1 , Hirohiko Motoki  1 , Koichiro Kuwahara  1
Affiliations

Outcome of transvenous lead extraction in nonagenarians: A single-center retrospective study

Toshinori Komatsu et al. Pacing Clin Electrophysiol. 2024 Oct.

Abstract

Background: Transvenous lead extraction (TLE) for cardiovascular implantable electronic device (CIED)-related infections has increased. The incidence of TLE in nonagenarians is low, with limited reports outlining the outcomes of this procedure. Therefore, in this study, we aimed to clarify the outcomes of TLE in nonagenarians.

Methods: Patients with TLE treated at our hospital between 2014 and 2023 were retrospectively examined; patient characteristics, device type, indications, procedures, complications, and clinical data of nonagenarians were analyzed.

Results: Of 12 patients with 24 leads (active fixation lead, n = 11; passive fixation lead, n = 13) who underwent TLE, the indication for TLE was infection (pocket infection, n = 8; sepsis, n = 4). Methicillin-resistant Staphylococcus epidermidis was the most frequently identified causative agent (n = 4). The median patient age was 91 years; five patients were female. The median lead dwell time was 9 years. Excimer laser sheath (16 leads), mechanical sheath (five leads), Evolution RL (one lead), and manual traction (two leads) were employed in TLE. The procedure was successful in all patients, and only one had a minor complication. Six patients required CIED re-implantation, and leadless pacemakers were selected for five patients. The 30-day mortality after TLE was 0%.

Conclusion: TLE can be safely performed in nonagenarians. The decision to perform TLE should not be based on old age alone; the suitability of removing infected CIEDs should be determined based on each patient's condition.

Keywords: cardiovascular implantable electronic device; complication; device infection; leadless pacemaker; nonagenarian; transvenous lead extraction.

PubMed Disclaimer

References

REFERENCES

    1. Wilkoff BL, Love CJ, Byrd CL, et al. Transvenous lead extraction: heart Rhythm Society expert consensus on facilities, training, indications, and patient management: this document was endorsed by the American Heart Association (AHA). Heart Rhythm. 2009;6:1085‐1104.
    1. Okamura H, Yasuda S, Sato S, et al. Initial experience using excimer laser for the extraction of chronically implanted pacemaker and implantable cardioverter defibrillator leads in Japanese patients. J Cardiol. 2013;62:195‐200.
    1. Nakajima H, Taki M. Incidence of cardiac implantable electronic device infections and migrations in Japan: results from a 129 institute survey. J Arrhythm. 2016;32:303‐307.
    1. Deharo JC, Quatre A, Mancini J, et al. Long‐term outcomes following infection of cardiac implantable electronic devices: a prospective matched cohort study. Heart. 2012;98:724‐731.
    1. Kennergren C, Bucknall CA, Butter C, et al. Laser‐assisted lead extraction: the European experience. Europace. 2007;9:651‐656.

LinkOut - more resources