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Transvenous Lead Extraction without Procedure-Related Deaths in 1000 Consecutive Patients: A Single-Center Experience
BACKGROUND: Transvenous lead extraction (TLE) is now a first-line technique for the treatment of complications related to cardiac implantable electronic devices. The aim of the study was to demonstrate that it is possible to safely perform difficult TLE procedures with a maximum reduction of peri-pr...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352641/ https://www.ncbi.nlm.nih.gov/pubmed/34385818 http://dx.doi.org/10.2147/VHRM.S318205 |
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author | Stefańczyk, Paweł Nowosielecka, Dorota Tułecki, Łukasz Tomków, Konrad Polewczyk, Anna Jacheć, Wojciech Kleinrok, Andrzej Borzęcki, Wojciech Kutarski, Andrzej |
author_facet | Stefańczyk, Paweł Nowosielecka, Dorota Tułecki, Łukasz Tomków, Konrad Polewczyk, Anna Jacheć, Wojciech Kleinrok, Andrzej Borzęcki, Wojciech Kutarski, Andrzej |
author_sort | Stefańczyk, Paweł |
collection | PubMed |
description | BACKGROUND: Transvenous lead extraction (TLE) is now a first-line technique for the treatment of complications related to cardiac implantable electronic devices. The aim of the study was to demonstrate that it is possible to safely perform difficult TLE procedures with a maximum reduction of peri-procedural major complications. METHODS: A total of 1000 consecutive patients undergoing TLE in a single high-volume center from 2016 to 2019 were studied. All procedures were performed in a hybrid room or operating room by a specialized TLE team. TLE was performed under general anesthesia and monitored by transesophageal echocardiography, and the operating room was suitably equipped for immediate surgical intervention. The effectiveness and safety of the procedures were assessed, with particular emphasis on major complications. RESULTS: In all, 1952 leads with the mean implant duration of 111.7 ± 77.6 months had been extracted. Complete procedural success of patients was achieved in 95.9% and clinical success in 99.1%. Major complications, predominantly cardiac tamponade (63.3%), occurred in 22 patients (2.2%). Rapid diagnosis and immediate intervention were the key to a 100% survival in patients with this complication. CONCLUSION: Performing procedures in a hybrid operating room under general anesthesia in the presence of a cardiac surgeon and with the use of transesophageal echocardiography significantly improves the safety of transvenous lead extraction. |
format | Online Article Text |
id | pubmed-8352641 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-83526412021-08-11 Transvenous Lead Extraction without Procedure-Related Deaths in 1000 Consecutive Patients: A Single-Center Experience Stefańczyk, Paweł Nowosielecka, Dorota Tułecki, Łukasz Tomków, Konrad Polewczyk, Anna Jacheć, Wojciech Kleinrok, Andrzej Borzęcki, Wojciech Kutarski, Andrzej Vasc Health Risk Manag Original Research BACKGROUND: Transvenous lead extraction (TLE) is now a first-line technique for the treatment of complications related to cardiac implantable electronic devices. The aim of the study was to demonstrate that it is possible to safely perform difficult TLE procedures with a maximum reduction of peri-procedural major complications. METHODS: A total of 1000 consecutive patients undergoing TLE in a single high-volume center from 2016 to 2019 were studied. All procedures were performed in a hybrid room or operating room by a specialized TLE team. TLE was performed under general anesthesia and monitored by transesophageal echocardiography, and the operating room was suitably equipped for immediate surgical intervention. The effectiveness and safety of the procedures were assessed, with particular emphasis on major complications. RESULTS: In all, 1952 leads with the mean implant duration of 111.7 ± 77.6 months had been extracted. Complete procedural success of patients was achieved in 95.9% and clinical success in 99.1%. Major complications, predominantly cardiac tamponade (63.3%), occurred in 22 patients (2.2%). Rapid diagnosis and immediate intervention were the key to a 100% survival in patients with this complication. CONCLUSION: Performing procedures in a hybrid operating room under general anesthesia in the presence of a cardiac surgeon and with the use of transesophageal echocardiography significantly improves the safety of transvenous lead extraction. Dove 2021-08-05 /pmc/articles/PMC8352641/ /pubmed/34385818 http://dx.doi.org/10.2147/VHRM.S318205 Text en © 2021 Stefańczyk et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Stefańczyk, Paweł Nowosielecka, Dorota Tułecki, Łukasz Tomków, Konrad Polewczyk, Anna Jacheć, Wojciech Kleinrok, Andrzej Borzęcki, Wojciech Kutarski, Andrzej Transvenous Lead Extraction without Procedure-Related Deaths in 1000 Consecutive Patients: A Single-Center Experience |
title | Transvenous Lead Extraction without Procedure-Related Deaths in 1000 Consecutive Patients: A Single-Center Experience |
title_full | Transvenous Lead Extraction without Procedure-Related Deaths in 1000 Consecutive Patients: A Single-Center Experience |
title_fullStr | Transvenous Lead Extraction without Procedure-Related Deaths in 1000 Consecutive Patients: A Single-Center Experience |
title_full_unstemmed | Transvenous Lead Extraction without Procedure-Related Deaths in 1000 Consecutive Patients: A Single-Center Experience |
title_short | Transvenous Lead Extraction without Procedure-Related Deaths in 1000 Consecutive Patients: A Single-Center Experience |
title_sort | transvenous lead extraction without procedure-related deaths in 1000 consecutive patients: a single-center experience |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8352641/ https://www.ncbi.nlm.nih.gov/pubmed/34385818 http://dx.doi.org/10.2147/VHRM.S318205 |
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