Long-term mortality after transvenous lead extraction

Circulation. Arrhythmia and Electrophysiology
Melanie MaytinLaurence M Epstein

Abstract

The number of cardiovascular implantable electronic devices has increased progressively and has led to an increased need for transvenous lead extraction (TLE). Multiple reports of TLE procedural outcomes exist; however, data regarding postprocedural and long-term mortality are limited. We performed a retrospective study of consecutive patients undergoing TLE at a single, high-volume center. Patient characteristics, indications, and outcomes were analyzed. A multivariable Cox regression model was developed to identify factors associated with mortality. Between January 2000 and December 2010, 985 patients underwent 1043 TLE procedures. The cohort was 68% male, with a mean age of 63 years (range, 15-95 years) and a left ventricular ejection fraction of 40±17%. Indications included systemic infection (18%), pocket infection (32%), lead malfunction (30%), and other (device upgrade, venous occlusion, and advisory leads; 20%). There were no procedure-related deaths. The mean follow-up was 3.7 years (range, 0.1-11.3 years). Kaplan-Meier analysis demonstrated a cumulative mortality of 2.1% at 30 days, 4.2% at 3 months, 8.4% at 1 year, and 46.8% at 10 years. In multivariable analysis, systemic infection (hazard ratio [HR], 3.52; 95% CI, ...Continue Reading

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