Comparison of outcomes in infected cardiovascular implantable electronic devices between complete, partial, and failed lead removal : an ESC-EHRA-EORP ELECTRa (European Lead Extraction ConTrolled) registry
(2019) In Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 21(12). p.1876-1889- Abstract
AIMS: The present study sought to determine predictors for success and outcomes of patients who underwent cardiac implantable electronic devices (CIED) extraction indicated for systemic or local CIED related infection in particular where complete lead removal could not be achieved.
METHODS AND RESULTS: ESC-EORP ELECTRa (European Lead Extraction ConTRolled Registry) is a European prospective lead extraction registry. Out of the total cohort, 1865/3510 (52.5%) patients underwent removal due to CIED related infection. Predictors and outcomes of failure were analysed. Complete removal was achieved in 1743 (93.5%) patients, partial (<4 cm of lead left) in 88 (4.7%), and failed (>4 cm of lead left) in 32 (1.8%) patients. Removal... (More)
AIMS: The present study sought to determine predictors for success and outcomes of patients who underwent cardiac implantable electronic devices (CIED) extraction indicated for systemic or local CIED related infection in particular where complete lead removal could not be achieved.
METHODS AND RESULTS: ESC-EORP ELECTRa (European Lead Extraction ConTRolled Registry) is a European prospective lead extraction registry. Out of the total cohort, 1865/3510 (52.5%) patients underwent removal due to CIED related infection. Predictors and outcomes of failure were analysed. Complete removal was achieved in 1743 (93.5%) patients, partial (<4 cm of lead left) in 88 (4.7%), and failed (>4 cm of lead left) in 32 (1.8%) patients. Removal success was unrelated to type of CIED infection (pocket or systemic). Predictors for failure were older leads and older patients [odds ratio (OR) 1.14 (1.08-1.19), P < 0.0001 and OR 2.68 (1.22-5.91), P = 0.0146, respectively]. In analysis by lead, predictors for failure were: pacemaker vs. defibrillator removal and failure to engage the locking stylet all the way to the tip [OR 0.20 (0.04-0.95), P = 0.03 and OR 0.32 (0.13-0.74), P = 0.008, respectively]. Significantly higher complication rates were noted in the failure group (40.6% vs. 15.9 for partial and 8.7% for success groups, P < 0.0001). Failure to remove a lead was a strong predictor for in hospital mortality [hazard ratio of 2.05 (1.01-4.16), P = 0.046].
CONCLUSION: A total of 6.5% of infected CIED patients failed attempted extraction. Only were >4 cm of lead remained resulted in higher procedural complications and mortality rates.
(Less)
- author
- Nof, Eyal
; Bongiorni, Maria Grazia
; Auricchio, Angelo
; Butter, Christian
; Dagres, Nikolaos
; Deharo, Jean-Claude
; Rinaldi, Christopher A
; Maggioni, Aldo P
; Kutarski, Andrzej
; Kennergren, Charles
; Laroche, Cécile
; Milman, Anat
; Beinart, Roy
; Bogdan, Stefan
; Mortsell, David
LU
; Calvi, Valeria
; Desiron, Quentin
; Mansourati, Jacques
; Lundqvist, Carina Blomstrom
and Glikson, Michael
(Less) - author collaboration
- publishing date
- 2019-10-18
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
- volume
- 21
- issue
- 12
- pages
- 1876 - 1889
- publisher
- Oxford University Press
- external identifiers
-
- pmid:31625553
- scopus:85077991860
- ISSN
- 1532-2092
- DOI
- 10.1093/europace/euz269
- language
- English
- LU publication?
- no
- additional info
- Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.
- id
- 36206c65-d4f5-4d37-a287-1d528e846cfd
- date added to LUP
- 2019-12-02 20:39:14
- date last changed
- 2024-04-02 20:51:55
@article{36206c65-d4f5-4d37-a287-1d528e846cfd,
abstract = {{<p>AIMS: The present study sought to determine predictors for success and outcomes of patients who underwent cardiac implantable electronic devices (CIED) extraction indicated for systemic or local CIED related infection in particular where complete lead removal could not be achieved.</p><p>METHODS AND RESULTS: ESC-EORP ELECTRa (European Lead Extraction ConTRolled Registry) is a European prospective lead extraction registry. Out of the total cohort, 1865/3510 (52.5%) patients underwent removal due to CIED related infection. Predictors and outcomes of failure were analysed. Complete removal was achieved in 1743 (93.5%) patients, partial (<4 cm of lead left) in 88 (4.7%), and failed (>4 cm of lead left) in 32 (1.8%) patients. Removal success was unrelated to type of CIED infection (pocket or systemic). Predictors for failure were older leads and older patients [odds ratio (OR) 1.14 (1.08-1.19), P < 0.0001 and OR 2.68 (1.22-5.91), P = 0.0146, respectively]. In analysis by lead, predictors for failure were: pacemaker vs. defibrillator removal and failure to engage the locking stylet all the way to the tip [OR 0.20 (0.04-0.95), P = 0.03 and OR 0.32 (0.13-0.74), P = 0.008, respectively]. Significantly higher complication rates were noted in the failure group (40.6% vs. 15.9 for partial and 8.7% for success groups, P < 0.0001). Failure to remove a lead was a strong predictor for in hospital mortality [hazard ratio of 2.05 (1.01-4.16), P = 0.046].</p><p>CONCLUSION: A total of 6.5% of infected CIED patients failed attempted extraction. Only were >4 cm of lead remained resulted in higher procedural complications and mortality rates.</p>}},
author = {{Nof, Eyal and Bongiorni, Maria Grazia and Auricchio, Angelo and Butter, Christian and Dagres, Nikolaos and Deharo, Jean-Claude and Rinaldi, Christopher A and Maggioni, Aldo P and Kutarski, Andrzej and Kennergren, Charles and Laroche, Cécile and Milman, Anat and Beinart, Roy and Bogdan, Stefan and Mortsell, David and Calvi, Valeria and Desiron, Quentin and Mansourati, Jacques and Lundqvist, Carina Blomstrom and Glikson, Michael}},
issn = {{1532-2092}},
language = {{eng}},
month = {{10}},
number = {{12}},
pages = {{1876--1889}},
publisher = {{Oxford University Press}},
series = {{Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology}},
title = {{Comparison of outcomes in infected cardiovascular implantable electronic devices between complete, partial, and failed lead removal : an ESC-EHRA-EORP ELECTRa (European Lead Extraction ConTrolled) registry}},
url = {{http://dx.doi.org/10.1093/europace/euz269}},
doi = {{10.1093/europace/euz269}},
volume = {{21}},
year = {{2019}},
}