Haeberlin, Andreas; Noti, Fabian; Breitenstein, Alexander; Auricchio, Angelo; Reichlin, Tobias; Conte, Giulio; Klersy, Catherine; Curti, Moreno; Pruvot, Etienne; Domenichini, Giulia; Schaer, Beat; Kühne, Michael; Gruszczynski, Michal; Burri, Haran; Kobza, Richard; Grebmer, Christian; Regoli, François D (2023). Transvenous Lead Extraction during Cardiac Implantable Device Upgrade: Results from the Multicenter Swiss Lead Extraction Registry. Journal of clinical medicine, 12(16) MDPI 10.3390/jcm12165175
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BACKGROUND
Device patients may require upgrade interventions from simpler to more complex cardiac implantable electronic devices. Prior to upgrading interventions, clinicians need to balance the risks and benefits of transvenous lead extraction (TLE), additional lead implantation or lead abandonment. However, evidence on procedural outcomes of TLE at the time of device upgrade is scarce.
METHODS
This is a post hoc analysis of the investigator-initiated multicenter Swiss TLE registry. The objectives were to assess patient and procedural factors influencing TLE outcomes at the time of device upgrades.
RESULTS
941 patients were included, whereof 83 (8.8%) had TLE due to a device upgrade. Rotational mechanical sheaths were more often used in upgraded patients (59% vs. 42.7%, p = 0.015) and total median procedure time was longer in these patients (160 min vs. 105 min, p < 0.001). Clinical success rates of upgraded patients compared to those who received TLE due to other reasons were not different (97.6% vs. 93.0%, p = 0.569). Moreover, multivariable analysis showed that upgrade procedures were not associated with a greater risk for complications (HR 0.48, 95% confidence interval 0.14-1.57, p = 0.224; intraprocedural complication rate of upgraded patients 7.2% vs. 5.5%). Intraprocedural complications of upgraded patients were mostly associated with the implantation and not the extraction procedure (67% vs. 33% of complications).
CONCLUSIONS
TLE during device upgrade is effective and does not attribute a disproportionate risk to the upgrade procedure.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Häberlin, Andreas David Heinrich, Noti, Fabian, Reichlin, Tobias Roman |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2077-0383 |
Publisher: |
MDPI |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
30 Aug 2023 10:08 |
Last Modified: |
30 Aug 2023 10:18 |
Publisher DOI: |
10.3390/jcm12165175 |
PubMed ID: |
37629216 |
Uncontrolled Keywords: |
lead extraction complications lead extraction indication lead extraction risk factors transvenous lead extraction upgrade procedure |
BORIS DOI: |
10.48350/185769 |
URI: |
https://boris.unibe.ch/id/eprint/185769 |
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