Vol 71, No 2 (2013)
Original articles
Published online: 2013-02-19
Safety and effectiveness of transvenous extraction of pacemaker and implantable cardioverter-defibrillator leads in patients under or over 80 years of age
DOI: 10.5603/KP.2013.0005
Kardiol Pol 2013;71(2):130-135.
Abstract
Background: Progressive aging of the population and the increasing number of complications of electrotherapy procedures
are the main reasons of a remarkable increase in the number of transvenous extraction procedures of pacemaker (PM) and
implantable cardioverter-defibrillator (ICD) leads in the elderly patients.
Aim: To assess the safety and effectiveness of such procedures in patients under or over 80 years of age. The study included
all patients who underwent transvenous PM/ICD lead extraction in 2003–2011.
Methods: All patients were divided into two groups based on their age at the time of the procedure: group A included patients
under 80 years of age (134 patients; 97 male, 37 female) and group B included patients over 80 years of age (26 patients;
16 male, 10 female).
Results: No differences were found between the two groups in terms of gender proportions, comorbidities, New York Heart
Association (NYHA) functional class, and left ventricular ejection fraction. In total, 220 leads were removed (group A: 63 defibrillating
and 122 pacing leads, group B: 2 defibrillating and 33 pacing leads). The most common indication for the lead
removal procedure in both groups was infection, either in the form of PM/ICD pocket infection (46 and 13 cases, respectively)
or infective endocarditis (18 and 2 cases, respectively). Procedural outcomes in both groups were not statistically different
in terms of the final outcome or complication rates. The results in groups A and B were as follows: complete success 95.5%
vs. 96.2%, respectively, clinical success 3% vs. 3.8%, respectively, and failure 1.5% vs. 0%, respectively, with no significant
differences between the groups. No major complications of the procedure were observed in either of the groups.
Conclusions: Our findings indicate that transvenous extraction of PM/ICD leads appears to be a safe and effective procedure
both in relatively younger patients and in patients over 80 years of age.
are the main reasons of a remarkable increase in the number of transvenous extraction procedures of pacemaker (PM) and
implantable cardioverter-defibrillator (ICD) leads in the elderly patients.
Aim: To assess the safety and effectiveness of such procedures in patients under or over 80 years of age. The study included
all patients who underwent transvenous PM/ICD lead extraction in 2003–2011.
Methods: All patients were divided into two groups based on their age at the time of the procedure: group A included patients
under 80 years of age (134 patients; 97 male, 37 female) and group B included patients over 80 years of age (26 patients;
16 male, 10 female).
Results: No differences were found between the two groups in terms of gender proportions, comorbidities, New York Heart
Association (NYHA) functional class, and left ventricular ejection fraction. In total, 220 leads were removed (group A: 63 defibrillating
and 122 pacing leads, group B: 2 defibrillating and 33 pacing leads). The most common indication for the lead
removal procedure in both groups was infection, either in the form of PM/ICD pocket infection (46 and 13 cases, respectively)
or infective endocarditis (18 and 2 cases, respectively). Procedural outcomes in both groups were not statistically different
in terms of the final outcome or complication rates. The results in groups A and B were as follows: complete success 95.5%
vs. 96.2%, respectively, clinical success 3% vs. 3.8%, respectively, and failure 1.5% vs. 0%, respectively, with no significant
differences between the groups. No major complications of the procedure were observed in either of the groups.
Conclusions: Our findings indicate that transvenous extraction of PM/ICD leads appears to be a safe and effective procedure
both in relatively younger patients and in patients over 80 years of age.
Keywords: transvenous lead extractionelderly
