Transvenous Lead Extraction in Adult Patient with Leads Implanted in Childhood-Is That the Same Procedure as in Other Adult Patients?

Andrzej Kutarski, Wojciech Jacheć, Anna Polewczyk, Dorota Nowosielecka, Maria Miszczak-Knecht, Monika Brzezinska and Katarzyna Bieganowska
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Andrzej Kutarski: Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland
Wojciech Jacheć: 2nd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Silesian Medical University, 41-800 Katowice, Poland
Anna Polewczyk: Department of Physiology, Patophysiology and Clinical Immunology, Institute of Medical Sciences, Jan Kochanowski University, 25-369 Kielce, Poland
Dorota Nowosielecka: Department of Cardiology, The Pope John Paul II Province Hospital, 22-400 Zamość, Poland
Maria Miszczak-Knecht: Department of Cardiology, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland
Monika Brzezinska: Department of Cardiology, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland
Katarzyna Bieganowska: Department of Cardiology, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland

IJERPH, 2022, vol. 19, issue 21, 1-17

Abstract: Background: Lead management in children and young adults is still a matter of debate. Methods: To assess the course of transvenous lead extraction (TLE) in adults with pacemakers implanted in childhood (CIP) we compared 98 CIP patients with a control group consisting of adults with pacemakers implanted in adulthood (AIP). Results: CIP patients differed from AIP patients with respect to indications for TLE and pacing history. CIP patients were four–eight times more likely to require second-line or advanced tools. Furthermore, CIP patients more often than AIP were prone to developing complications: major complications (MC) (any) 2.6 times; hemopericardium 3.2 times; severe tricuspid valve damage 4.4 times; need for rescue cardiac surgery 3.7 times. The rate of procedural success was 11% lower because of 4.8 times more common lead remnants and 3.1 times more frequent permanently disabling complications. Conclusions: Due to system-related risk factors TLE in CIP patients is more difficult and complex. TLE in CIP is associated with an increased risk of MC and incomplete lead removal. A conservative strategy of lead management, acceptable in very old patients seems to be less suitable in CIP because it creates a subpopulation of patients at high risk of major complications during TLE in the future.

Keywords: pacing in children; lead extraction in young adults; complications of pacing; lead extraction complexity (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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