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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...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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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 |
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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 |
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