What question did this study set out to answer?

To identify clinical and procedural predictors of 30-day complications following endovascular chronic cardiac rhythm management lead extractions.

September 4, 2008Journal of Cardiovascular Electrophysiology

Predictors of Complications of Endovascular Chronic Lead Extractions from Pacemakers and Defibrillators: A Single‐Operator Experience

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Why the study?

What are the predictors of complications following endovascular chronic lead extraction from pacemakers and defibrillators?

Key Points

To identify clinical and procedural predictors of 30-day complications following endovascular chronic cardiac rhythm management lead extractions.
Analyzed consecutive patients (N=212; 456 leads; mean age 65 ± 17 years, 75% men) undergoing endovascular chronic lead extractions at a single institution between 2002 and 2008.
Evaluated procedural characteristics, baseline patient demographics, and major and minor adverse events occurring within 30 days post-procedure.
Overall complications occurred in 11.8% of patients (n=26 in 25 patients), consisting of 4.2% major complications (1 death, 4 hemothorax, 2 pneumothorax, 1 tamponade, 1 stroke) and 8.0% minor complications.
A higher number of explanted right ventricular leads was an independent predictor of any complication (HR = 3.51, P = 0.013), while explanting an ICD versus a pacemaker showed a strong trend (HR = 2.57, P = 0.053).
An elevated baseline white blood cell count independently predicted the occurrence of major procedural complications (HR = 1.52, P = 0.005).

Structured PICO

What are the predictors of complications following endovascular chronic lead extraction from pacemakers and defibrillators?

Population

212 consecutive patients (456 leads) who underwent endovascular chronic cardiac rhythm management (CRM) lead extraction at a single institution between 2002 and 2008. Mean age 65 +/- 17 years, 75% men, LVEF 36 +/- 16%, coronary artery disease 80%, defibrillators 49%.

Intervention

Endovascular chronic CRM lead extraction

Outcome

Complications within 30 days (major and minor)safety

A higher number of extracted leads and the presence of defibrillator leads are significant predictors of complications during chronic lead extraction, suggesting that early removal of unused leads may reduce future risk.

Discussion

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Implication

Multiple RV leads and elevated WBC identify higher-risk extraction patients; hypothesis-generating and requires prospective validation before practice impact.

Cite This Study

Agarwal et al. (2008) studied this question.

synapsesocial.com/papers/6a7114392fdcb5703edb6f49 https://doi.org/10.1111/j.1540-8167.2008.01283.x

Topics

Cardiac device therapy Coronary artery disease

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Implication

Multiple RV leads and elevated WBC identify higher-risk extraction patients; hypothesis-generating and requires prospective validation before practice impact.

Predictors of Complications of Endovascular Chronic Lead Extractions from Pacemakers and Defibrillators: A Single‐Operator Experience

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Predictors of Complications of Endovascular Chronic Lead Extractions from Pacemakers and Defibrillators: A Single‐Operator Experience

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider