What question did this study set out to answer?

To evaluate the safety, efficacy, and outcomes of transvenous lead extraction versus abandonment of non-infected superfluous leads during cardiac implantable electronic device revisions or upgrades.

February 1, 2021Современные технологии в медицинеOpen Access

The Use of Transvenous Lead Extraction of Non-Infected Leads to Prevent Long-Term Lead-Related Complications

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Why the study?

Deciding whether to abandon or remove non-infected superfluous leads during lead revisions or cardiac implantable electronic device upgrades remains challenging.

Does transvenous lead extraction prevent long-term lead-related complications compared to lead abandonment in patients with malfunctioning non-infected leads?

Key Points

To evaluate the safety, efficacy, and outcomes of transvenous lead extraction versus abandonment of non-infected superfluous leads during cardiac implantable electronic device revisions or upgrades.
Analyzed 126 patients (mean age 59.2±16.7 years) with 155 malfunctioning non-infected leads admitted for device replacement or revision between 2010 and 2019.
Divided patients based on lead age and clinical strategy into an extracted leads group (n=83; mean lead age 6.9±5.6 years) and an abandoned leads group (n=43; mean lead age ~12 years).
Lead extraction was performed via manual traction in 69 leads (61.7%), lead locking devices in 32 leads (28.5%), and rotating dilator sheaths in 11 leads (9.8%), alongside one thoracoscopic extraction for superior vena cava occlusion.
Lead-related complications occurred in 3 patients within the abandoned leads group, whereas extraction of leads under 10 years old demonstrated high efficacy and safety without long-term complications.

Structured PICO

Does transvenous lead extraction prevent long-term lead-related complications compared to lead abandonment in patients with malfunctioning non-infected leads?

Population

126 patients with 155 malfunctioning non-infected leads (identified from 482 patients admitted for generator replacement or lead revision), mean age 59.2±16.7 years. 10 cases had total venous occlusion.

Intervention

Transvenous lead extraction of non-infected leads (n=83 patients, mean lead age 6.9±5.6 years)

Comparator

Lead abandonment (n=43 patients, mean lead age about 12 years)

Outcome

Lead-related complications in the long-term periodsafety

Preventive transvenous lead extraction of non-infected leads, particularly those less than 10 years old, is an effective and safe strategy to avoid long-term lead-related complications compared to lead abandonment.

Discussion

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Implication

May support extraction to prevent abandoned-lead complications; leaves open confirmation by randomized trials.

Cite This Study

Ayvazyan et al. (2021) studied this question.

synapsesocial.com/papers/6a89d21441f4089922bd7a16 https://doi.org/10.17691/stm2021.13.1.08

Topics

Cardiac device therapy

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The Use of Transvenous Lead Extraction of Non-Infected Leads to Prevent Long-Term Lead-Related Complications

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

The Use of Transvenous Lead Extraction of Non-Infected Leads to Prevent Long-Term Lead-Related Complications

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider