Transvenous lead extraction in children is more complex and time-consuming than in adults, resulting in a significantly lower rate of complete procedural success (82.54% vs. 95.68%, P<0.001).
Observational (n=2,722)
Yes
Does transvenous lead extraction (TLE) differ in complexity, effectiveness, and safety between pediatric and adult patients?
Transvenous lead extraction in pediatric patients is more complex, time-consuming, and has lower procedural success rates compared to adults, likely due to strong fibrous tissue formation.
Absolute Event Rate: 82.54% vs 95.68%
p-value: p=<0.001
BACKGROUND: Cardiac implantable electronic devices (CIED) are very rare in the pediatric population. In children with CIED, transvenous lead extraction (TLE) is often necessary. The course and effects of TLE in children are different than in adults. Thus, this study determined the differences and specific characteristics of TLE in children vs. adults. METHODS AND RESULTS: A post hoc analysis of TLE data in 63 children (age ≤18 years) and 2,659 adults (age ≥40 years) was performed. The 2 groups were compared with respect to risk factors, procedure complexity, and effectiveness. In children, the predominant pacing mode was a single chamber ventricular system and lead dysfunction was the main indication for lead extraction. The mean implant duration before TLE was longer in children (P=0.03), but the dwell time of the oldest extracted lead did not differ significantly between adults and children. The duration (P=0.006) and mean extraction time per lead (P<0.001) were longer in children, with more technical difficulties during TLE in the pediatric group (P<0.001). Major complications were more common, albeit not significantly, in children. Complete radiographic and procedural success were significantly lower in children (P<0.001). CONCLUSIONS: TLE in children is frequently more complex, time consuming, and arduous, and procedural success is more often lower. This is related to the formation of strong fibrous tissue surrounding the leads in pediatric patients.
Kutarski et al. (Tue,) conducted a observational in Cardiac implantable electronic device (CIED) lead extraction (n=2,722). Transvenous lead extraction in children vs. Transvenous lead extraction in adults was evaluated on Complete procedural success (p=<0.001). Transvenous lead extraction in children is more complex and time-consuming than in adults, resulting in a significantly lower rate of complete procedural success (82.54% vs. 95.68%, P<0.001).