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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...

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Autores principales: Stefańczyk, Paweł, Nowosielecka, Dorota, Tułecki, Łukasz, Tomków, Konrad, Polewczyk, Anna, Jacheć, Wojciech, Kleinrok, Andrzej, Borzęcki, Wojciech, Kutarski, Andrzej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
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.
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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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