Cargando…

Transvenous Lead Extraction during Cardiac Implantable Device Upgrade: Results from the Multicenter Swiss Lead Extraction Registry

Background: Device patients may require upgrade interventions from simpler to more complex cardiac implantable electronic devices. Prior to upgrading interventions, clinicians need to balance the risks and benefits of transvenous lead extraction (TLE), additional lead implantation or lead abandonmen...

Descripción completa

Detalles Bibliográficos
Autores principales: Haeberlin, Andreas, Noti, Fabian, Breitenstein, Alexander, Auricchio, Angelo, Reichlin, Tobias, Conte, Giulio, Klersy, Catherine, Curti, Moreno, Pruvot, Etienne, Domenichini, Giulia, Schaer, Beat, Kühne, Michael, Gruszczynski, Michal, Burri, Haran, Kobza, Richard, Grebmer, Christian, Regoli, François D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455660/
https://www.ncbi.nlm.nih.gov/pubmed/37629216
http://dx.doi.org/10.3390/jcm12165175
_version_ 1785096506434387968
author Haeberlin, Andreas
Noti, Fabian
Breitenstein, Alexander
Auricchio, Angelo
Reichlin, Tobias
Conte, Giulio
Klersy, Catherine
Curti, Moreno
Pruvot, Etienne
Domenichini, Giulia
Schaer, Beat
Kühne, Michael
Gruszczynski, Michal
Burri, Haran
Kobza, Richard
Grebmer, Christian
Regoli, François D.
author_facet Haeberlin, Andreas
Noti, Fabian
Breitenstein, Alexander
Auricchio, Angelo
Reichlin, Tobias
Conte, Giulio
Klersy, Catherine
Curti, Moreno
Pruvot, Etienne
Domenichini, Giulia
Schaer, Beat
Kühne, Michael
Gruszczynski, Michal
Burri, Haran
Kobza, Richard
Grebmer, Christian
Regoli, François D.
author_sort Haeberlin, Andreas
collection PubMed
description Background: Device patients may require upgrade interventions from simpler to more complex cardiac implantable electronic devices. Prior to upgrading interventions, clinicians need to balance the risks and benefits of transvenous lead extraction (TLE), additional lead implantation or lead abandonment. However, evidence on procedural outcomes of TLE at the time of device upgrade is scarce. Methods: This is a post hoc analysis of the investigator-initiated multicenter Swiss TLE registry. The objectives were to assess patient and procedural factors influencing TLE outcomes at the time of device upgrades. Results: 941 patients were included, whereof 83 (8.8%) had TLE due to a device upgrade. Rotational mechanical sheaths were more often used in upgraded patients (59% vs. 42.7%, p = 0.015) and total median procedure time was longer in these patients (160 min vs. 105 min, p < 0.001). Clinical success rates of upgraded patients compared to those who received TLE due to other reasons were not different (97.6% vs. 93.0%, p = 0.569). Moreover, multivariable analysis showed that upgrade procedures were not associated with a greater risk for complications (HR 0.48, 95% confidence interval 0.14–1.57, p = 0.224; intraprocedural complication rate of upgraded patients 7.2% vs. 5.5%). Intraprocedural complications of upgraded patients were mostly associated with the implantation and not the extraction procedure (67% vs. 33% of complications). Conclusions: TLE during device upgrade is effective and does not attribute a disproportionate risk to the upgrade procedure.
format Online
Article
Text
id pubmed-10455660
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-104556602023-08-26 Transvenous Lead Extraction during Cardiac Implantable Device Upgrade: Results from the Multicenter Swiss Lead Extraction Registry Haeberlin, Andreas Noti, Fabian Breitenstein, Alexander Auricchio, Angelo Reichlin, Tobias Conte, Giulio Klersy, Catherine Curti, Moreno Pruvot, Etienne Domenichini, Giulia Schaer, Beat Kühne, Michael Gruszczynski, Michal Burri, Haran Kobza, Richard Grebmer, Christian Regoli, François D. J Clin Med Article Background: Device patients may require upgrade interventions from simpler to more complex cardiac implantable electronic devices. Prior to upgrading interventions, clinicians need to balance the risks and benefits of transvenous lead extraction (TLE), additional lead implantation or lead abandonment. However, evidence on procedural outcomes of TLE at the time of device upgrade is scarce. Methods: This is a post hoc analysis of the investigator-initiated multicenter Swiss TLE registry. The objectives were to assess patient and procedural factors influencing TLE outcomes at the time of device upgrades. Results: 941 patients were included, whereof 83 (8.8%) had TLE due to a device upgrade. Rotational mechanical sheaths were more often used in upgraded patients (59% vs. 42.7%, p = 0.015) and total median procedure time was longer in these patients (160 min vs. 105 min, p < 0.001). Clinical success rates of upgraded patients compared to those who received TLE due to other reasons were not different (97.6% vs. 93.0%, p = 0.569). Moreover, multivariable analysis showed that upgrade procedures were not associated with a greater risk for complications (HR 0.48, 95% confidence interval 0.14–1.57, p = 0.224; intraprocedural complication rate of upgraded patients 7.2% vs. 5.5%). Intraprocedural complications of upgraded patients were mostly associated with the implantation and not the extraction procedure (67% vs. 33% of complications). Conclusions: TLE during device upgrade is effective and does not attribute a disproportionate risk to the upgrade procedure. MDPI 2023-08-08 /pmc/articles/PMC10455660/ /pubmed/37629216 http://dx.doi.org/10.3390/jcm12165175 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Haeberlin, Andreas
Noti, Fabian
Breitenstein, Alexander
Auricchio, Angelo
Reichlin, Tobias
Conte, Giulio
Klersy, Catherine
Curti, Moreno
Pruvot, Etienne
Domenichini, Giulia
Schaer, Beat
Kühne, Michael
Gruszczynski, Michal
Burri, Haran
Kobza, Richard
Grebmer, Christian
Regoli, François D.
Transvenous Lead Extraction during Cardiac Implantable Device Upgrade: Results from the Multicenter Swiss Lead Extraction Registry
title Transvenous Lead Extraction during Cardiac Implantable Device Upgrade: Results from the Multicenter Swiss Lead Extraction Registry
title_full Transvenous Lead Extraction during Cardiac Implantable Device Upgrade: Results from the Multicenter Swiss Lead Extraction Registry
title_fullStr Transvenous Lead Extraction during Cardiac Implantable Device Upgrade: Results from the Multicenter Swiss Lead Extraction Registry
title_full_unstemmed Transvenous Lead Extraction during Cardiac Implantable Device Upgrade: Results from the Multicenter Swiss Lead Extraction Registry
title_short Transvenous Lead Extraction during Cardiac Implantable Device Upgrade: Results from the Multicenter Swiss Lead Extraction Registry
title_sort transvenous lead extraction during cardiac implantable device upgrade: results from the multicenter swiss lead extraction registry
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455660/
https://www.ncbi.nlm.nih.gov/pubmed/37629216
http://dx.doi.org/10.3390/jcm12165175
work_keys_str_mv AT haeberlinandreas transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT notifabian transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT breitensteinalexander transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT auricchioangelo transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT reichlintobias transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT contegiulio transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT klersycatherine transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT curtimoreno transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT pruvotetienne transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT domenichinigiulia transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT schaerbeat transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT kuhnemichael transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT gruszczynskimichal transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT burriharan transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT kobzarichard transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT grebmerchristian transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry
AT regolifrancoisd transvenousleadextractionduringcardiacimplantabledeviceupgraderesultsfromthemulticenterswissleadextractionregistry