Repeat Transvenous Lead Extraction—Predictors, Effectiveness, Complications and Long-Term Prognostic Significance

Andrzej Kutarski, Wojciech Jacheć, Dorota Nowosielecka (), Marek Czajkowski, Łukasz Tułecki and Anna Polewczyk
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Andrzej Kutarski: Department of Cardiology, Medical University, 20-059 Lublin, Poland
Wojciech Jacheć: 2nd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Katowice, Poland
Dorota Nowosielecka: Department of Cardiology, The Pope John Paul II Province Hospital, 22-400 Zamość, Poland
Marek Czajkowski: Department of Cardiac Surgery, Medical University, 20-059 Lublin, Poland
Łukasz Tułecki: Department of Cardiac Surgery, The Pope John Paul II Province Hospital, 22-400 Zamość, Poland
Anna Polewczyk: Institute of Medical Sciences, Jan Kochanowski University, 25-369 Kielce, Poland

IJERPH, 2022, vol. 19, issue 23, 1-16

Abstract: Background: Data regarding repeat transvenous lead extraction (TLE) are scarce. The aim of study was to explore the frequency of repeat TLE, its safety, predisposing factors, as well as effectiveness of repeat procedures. Methods: Retrospective analysis of a large single-center database of 3654 TLEs. Results: Repeat TLE was a rare occurrence (193, i.e., 5,28% among 3654 TLEs). Subsequent re-extractions occurred in 12.21% of the patients. Lead failure was the most common cause of re-extraction (51.16%). Cox regression analysis showed that patients who were older at first implantation [HR = 0.987; p = 0.003], had infection-related TLE [HR = 0.392; p < 0.001] and complete procedural success [HR = 0.544; p = 0.034] were less likely to undergo repeat TLE. Functional leads left in place for continuous use [HR = 1.405; p = 0.012] or superfluous leads left in place (abandoned) [HR = 2.370; p = 0.011] were associated with an increased risk of undergoing a repeat procedure. Overall mortality in patients with repeat TLE and subsequent re-extraction in the entire FU period was similar to that in patients without a history of re-extraction [HR = 0.949; p = 0.480]. Conclusions: Repeat TLE was a rare occurrence (5.28%) among TLEs. Left of both active and nonactive leads during TLE increased the risk of re-extraction. Re-extraction has no effect on the long-term mortality.

Keywords: transvenous lead extraction; repeat extraction; safety; effectiveness; survival (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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