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The impact of transvenous lead extraction complications on the 12-month prognosis: insights from the SILCARD registry

Mateusz Tajstra1, Krzysztof Stanisław Golba23, Anna Kurek1, Wojciech Jacheć4, Ewa Nowolany-Kozielska4, Michał Skrzypek5, Katarzyna Mizia-Stec6, Eugeniusz Piłat2, Anna Drzewiecka2, Artur Filipecki6, Karol Przyłudzki7, Zbigniew Kalarus7, Mariusz Gąsior1, Adam Sokal7
DOI: 10.33963/KP.a2021.0141
·
Pubmed: 34668179
Affiliations
  1. 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Silesian Centre for Heart Diseases, Medical University of Silesia, Katowice, Poland
  2. Department of Electrocardiology, Upper-Silesian Heart Center, Katowice, Poland
  3. Department of Electrocardiology and Heart Failure, Medical University of Silesia, Katowice, Poland
  4. 2nd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
  5. Department of Biostatistics, School of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
  6. 1st Department of Cardiology, Medical Faculty in Katowice, Medical University of Silesia, Katowice, Poland
  7. 1st Department of Cardiology and Angiology, Silesian Center of Heart Diseases Zabrze, Medical University of Silesia, Katowice, Poland

open access

Online first
Original article
Published online: 2021-10-18

Abstract

Background: Scant data exist on long-term outcomes including death in patients with transvenous lead extractions (TLE) related complications.
Aims: We sought to characterize the population and examine the outcomes including risk factors for in-hospital complications and 12-month mortality and morbidity related to the complications in a large administrative database of patients undergoing TLE.
Results: From the database of patients hospitalized for cardiovascular diseases and included in the Silesian Cardiovascular Database (SILCARD) registry, we selected the admissions of those who underwent TLE according to the appropriate ICD-9 codes. The patients were divided into two groups based on whether they did or did not manifest any complications during their hospitalization for the TLE procedure. Between 2007 and 2019, we found a total of 835 patients who underwent TLE. TLE-related complications occurred in 56 patients (6.7%) of Complications-Yes, while no complications were recorded in 779 (93.3%) patients of Complications-No group. A significant difference in the rate of all-cause mortality (23.9% vs 6.5%; P < 0.001) and major adverse cardiac events (MACE) (58.7% vs 39.4%; P = 0.01) between the Complications-Yes and Complications-No group were recorded. A multivariable analysis of the entire study population revealed that prior dialysis, chronic kidney disease, and ventricular tachycardia were independent factors of a higher risk of TLE-related in-hospital complications. A multivariable analysis of the patients discharged from the hospital after the TLE procedure showed that TLE-related complications, the history of heart failure, and older age independently affected 12-month mortality.
Conclusions: The presence of TLE-related in-hospital complications increased 12-month mortality.

Abstract

Background: Scant data exist on long-term outcomes including death in patients with transvenous lead extractions (TLE) related complications.
Aims: We sought to characterize the population and examine the outcomes including risk factors for in-hospital complications and 12-month mortality and morbidity related to the complications in a large administrative database of patients undergoing TLE.
Results: From the database of patients hospitalized for cardiovascular diseases and included in the Silesian Cardiovascular Database (SILCARD) registry, we selected the admissions of those who underwent TLE according to the appropriate ICD-9 codes. The patients were divided into two groups based on whether they did or did not manifest any complications during their hospitalization for the TLE procedure. Between 2007 and 2019, we found a total of 835 patients who underwent TLE. TLE-related complications occurred in 56 patients (6.7%) of Complications-Yes, while no complications were recorded in 779 (93.3%) patients of Complications-No group. A significant difference in the rate of all-cause mortality (23.9% vs 6.5%; P < 0.001) and major adverse cardiac events (MACE) (58.7% vs 39.4%; P = 0.01) between the Complications-Yes and Complications-No group were recorded. A multivariable analysis of the entire study population revealed that prior dialysis, chronic kidney disease, and ventricular tachycardia were independent factors of a higher risk of TLE-related in-hospital complications. A multivariable analysis of the patients discharged from the hospital after the TLE procedure showed that TLE-related complications, the history of heart failure, and older age independently affected 12-month mortality.
Conclusions: The presence of TLE-related in-hospital complications increased 12-month mortality.

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Keywords

complications, implantable electronic devices, lead extraction, registry, safety

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About this article
Title

The impact of transvenous lead extraction complications on the 12-month prognosis: insights from the SILCARD registry

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2021-10-18

DOI

10.33963/KP.a2021.0141

Pubmed

34668179

Keywords

complications
implantable electronic devices
lead extraction
registry
safety

Authors

Mateusz Tajstra
Krzysztof Stanisław Golba
Anna Kurek
Wojciech Jacheć
Ewa Nowolany-Kozielska
Michał Skrzypek
Katarzyna Mizia-Stec
Eugeniusz Piłat
Anna Drzewiecka
Artur Filipecki
Karol Przyłudzki
Zbigniew Kalarus
Mariusz Gąsior
Adam Sokal

References (25)
  1. Raatikainen MJ, Arnar DO, Merkely B, et al. A decade of information on the use of cardiac implantable electronic devices and interventional electrophysiological procedures in the European Society of Cardiology countries: 2017 report from the European Heart Rhythm Association. Europace. 2017; 19(Suppl 2): ii1–ii90.
  2. Ponikowski P, Voors A, Anker S, et al. ESC Scientific Document Group. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC. European Heart Journal. 2016; 37(27): 2129–2200.
  3. Diemberger I, Mazzotti A, Giulia MB, et al. From lead management to implanted patient management: systematic review and meta-analysis of the last 15 years of experience in lead extraction. Expert Rev Med Devices. 2013; 10(4): 551–573.
  4. Bongiorni MG, Blomström-Lundqvist C, Kennergren C, et al. Scientific Initiative Committee, European Heart Rhythm Association. Current practice in transvenous lead extraction: a European Heart Rhythm Association EP Network Survey. Europace. 2012; 14(6): 783–786.
  5. Bongiorni MG, Marinskis G, Lip GYH, et al. Scientific Initiative Committee, European Heart Rhythm Association. How European centres diagnose, treat, and prevent CIED infections: results of an European Heart Rhythm Association survey. Europace. 2012; 14(11): 1666–1669.
  6. Bongiorni MG, Kennergren C, Butter C, et al. ELECTRa Investigators. The European Lead Extraction ConTRolled (ELECTRa) study: a European Heart Rhythm Association (EHRA) Registry of Transvenous Lead Extraction Outcomes. Eur Heart J. 2017; 38(40): 2995–3005.
  7. Bongiorni MG, Burri H, Deharo JC, et al. ESC Scientific Document Group. 2018 EHRA expert consensus statement on lead extraction: recommendations on definitions, endpoints, research trial design, and data collection requirements for clinical scientific studies and registries: endorsed by APHRS/HRS/LAHRS. Europace. 2018; 20(7): 1217.
  8. Hauser RG, Katsiyiannis WT, Gornick CC, et al. Deaths and cardiovascular injuries due to device-assisted implantable cardioverter-defibrillator and pacemaker lead extraction. Europace. 2010; 12(3): 395–401.
  9. Maytin M, Epstein LM, Henrikson CA. Lead extraction is preferred for lead revisions and system upgrades: when less is more. Circ Arrhythm Electrophysiol. 2010; 3(4): 413–424.
  10. Jacheć W, Polewczyk A, Polewczyk M, et al. Transvenous lead extraction SAFeTY score for risk stratification and proper patient selection for removal procedures using mechanical tools. J Clin Med. 2020; 9(2): 361.
  11. Gąsior M, Pres D, Wojakowski W, et al. Causes of hospitalization and prognosis in patients with cardiovascular diseases. Secular trends in the years 2006-2014 according to the SILesian CARDiovascular (SILCARD) database. Pol Arch Med Wewn. 2016; 126(10): 754–762.
  12. Brignole M, Auricchio A, Baron-Esquivias G, et al. ESC Committee for Practice Guidelines (CPG), Document Reviewers. 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Eur Heart J. 2013; 34(29): 2281–2329.
  13. Wazni O, Epstein LM, Carrillo RG, et al. Lead extraction in the contemporary setting: the LExICon study: an observational retrospective study of consecutive laser lead extractions. J Am Coll Cardiol. 2010; 55(6): 579–586.
  14. Sood N, Martin DT, Lampert R, et al. Incidence and predictors of perioperative complications with transvenous lead extractions: real-world experience with national cardiovascular data registry. Circ Arrhythm Electrophysiol. 2018; 11(2): e004768.
  15. Hosseini SM, Rozen G, Kaadan MI, et al. Safety and in-hospital outcomes of transvenous lead extraction for cardiac implantable device-related infections: analysis of 13 years of inpatient data in the United States. JACC Clin Electrophysiol. 2019; 5(12): 1450–1458.
  16. Katarzyńska-Szymańska A, Grymuza M, Chmielewska-Michalak L, et al. Implementation of laser equipment in a center experienced in lead extraction: safety and efficacy within 1-year follow-up. Kardiol Pol. 2021; 79(5): 569–571.
  17. Merchant FM, Levy MR, Kelli HM, et al. Predictors of long-term survival following transvenous extraction of defibrillator leads. Pacing Clin Electrophysiol. 2015; 38(11): 1297–1303.
  18. Brunner MP, Yu C, Hussein AA, et al. Nomogram for predicting 30-day all-cause mortality after transvenous pacemaker and defibrillator lead extraction. Heart Rhythm. 2015; 12(12): 2381–2386.
  19. Barakat AF, Wazni OM, Tarakji KG, et al. Transvenous lead extraction in chronic kidney disease and dialysis patients with infected cardiac devices. Circ Arrhythm Electrophysiol. 2018; 11(1): e005706.
  20. Lekkerkerker JC, van Nieuwkoop C, Trines SA, et al. Risk factors and time delay associated with cardiac device infections: Leiden device registry. Heart. 2009; 95(9): 715–720.
  21. Gomes JA, Mehta D, Ip J, et al. Predictors of long-term survival in patients with malignant ventricular arrhythmias. Am J Cardiol. 1997; 79(8): 1054–1060.
  22. Aleong RG, Zipse MM, Tompkins C, et al. Analysis of outcomes in 8304 patients undergoing lead extraction for infection. J Am Heart Assoc. 2020; 9(7): e011473.
  23. Tarakji KG, Wazni OM, Harb S, et al. Risk factors for 1-year mortality among patients with cardiac implantable electronic device infection undergoing transvenous lead extraction: the impact of the infection type and the presence of vegetation on survival. Europace. 2014; 16(10): 1490–1495.
  24. Maytin M, Jones SO, Epstein LM. Long-term mortality after transvenous lead extraction. Circ Arrhythm Electrophysiol. 2012; 5(2): 252–257.
  25. Nowosielecka D, Polewczyk A, Jacheć W, et al. Transesophageal echocardiography for the monitoring of transvenous lead extraction. Kardiol Pol. 2020; 78(12): 1206–1214.

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