Key result
In-hospital complications related to transvenous lead extraction independently increased 12-month mortality (OR 3.97) compared to patients who underwent the procedure without complications.
Why the study?
Scant data exist on long-term outcomes, including death, in patients with complications related to transvenous lead extractions.
Does the presence of in-hospital complications related to transvenous lead extraction increase 12-month mortality and MACE in patients undergoing TLE?
Cohort (n=835)
Yes
Does the presence of in-hospital complications related to transvenous lead extraction increase 12-month mortality and MACE in patients undergoing TLE?
Odds Ratio: 3.97 (95% CI 1.86–8.47)
Absolute Event Rate: 23.9% vs 6.5%
p-value: p=<0.001
In-hospital complications during transvenous lead extraction are associated with a significantly increased risk of 12-month mortality and major adverse cardiac events.
Registry data on TLE complications warrant procedural caution; leaves open optimal management strategies pending prospective trials.
BACKGROUND: Scant data exist on long-term outcomes, including death, in patients with complica-tions related to transvenous lead extractions (TLE). 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 the Complications-Yes group while no complications were recorded in 779 (93.3%) patients of the 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 groups were recorded. 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. Multivariable analysis of the patients discharged from the hospital after the TLE procedure showed that TLE-related complications, a 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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A 2022 study conducted a cohort in Patients undergoing transvenous lead extraction (TLE) (n=835). In-hospital complications related to transvenous lead extraction vs. No in-hospital complications was evaluated on 12-month all-cause mortality (OR 3.97, 95% CI 1.86-8.47, p=<0.001). In-hospital complications related to transvenous lead extraction independently increased 12-month mortality (OR 3.97) compared to patients who underwent the procedure without complications.
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