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- Title
Urwanie elektrody podczas zabiegu przezżylnego usuwania eletrod -- czynniki ryzyka i wpływ na wynik zabiegu. Analiza 3825 zabiegów.
- Authors
Kutarski, Andrzej; Jacheć, Wojciech; Czajkowski, Marek; Tułecki, Łukasz; Stefańczyk, Paweł; Nowosielecka, Dorota
- Abstract
BACKGROUND There are no reports describing lead break (LB) during transvenous lead extraction (TLE). METHODS Retrospective analysis of 3825 consecutive TLEs using mechanical sheaths. RESULTS Fracture of the lead defined as LB with a long lead fragment (LF) occurred in 2.48%, LB with a short LF in 1.20%, LB with the tip of the lead in 1.78% and LB with loss of a free-floating LF in 0.57% of cases. In total, extractions with LB occurred in 6.04%. In cases in which lead remnant was equivalent to a lead fragment (more than the lead tip only) there was a 50.31% chance of removing the LF in its entirety and an 18.41% chance of significantly reducing its length (to less than 4 cm). Risk factors for LB are similar to those for major complications and increased procedure complexity: long lead dwell time (OR = 1.018), higher LV ejection fraction, multiple previous CIED-related procedures and extraction of passive fixation leads. The LECOM and LED scores also have a high predictive value. All forms of LB were associated with increased procedure complexity and major complications (9.96 vs. 1.53%). There was no procedure-related death among such patients and LB did not affect survival statistics after TLE. CONCLUSIONS LB during TLE occurs in 6.04% of procedures and this predictable trouble increases procedure complexity and risk of major complications. Thus, the possibility of LB should be taken into account when planning lead extraction strategy and training.
- Subjects
POLAND; RISK assessment; MEDICAL device removal; TREATMENT effectiveness; CONFERENCES &; conventions; IMPLANTABLE cardioverter-defibrillators; MEDICAL equipment reliability; CARDIAC pacemakers
- Publication
Polish Heart Journal / Kardiologia Polska, 2024, Vol 82, p32
- ISSN
0022-9032
- Publication type
Article