In-Hospital and Midterm Outcomes of Lead Extraction: A Single-Center Clinical Study

Fahimeh  Valizadeh-Shiran; Negin Sadat Hosseini Mohammadi; Kiarash Tavakoli; Arash Jalali; Seyed Hossein Ahmadi Tafti; Ahmad Yaminisharif

doi:10.18502/jthc.v19i1.15533

Fahimeh Valizadeh-Shiran Department of Cardiac Electrophysiology, Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Negin Sadat Hosseini Mohammadi Department of Cardiac Electrophysiology, Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Kiarash Tavakoli Department of Cardiac Electrophysiology, Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Arash Jalali Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Seyed Hossein Ahmadi Tafti Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Ahmad Yaminisharif Department of Cardiac Electrophysiology, Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/jthc.v19i1.15533

Keywords: Lead; Implantable cardioverter-defibrillators; Cardiac resynchronization therapy; Cardiac resynchronization therapy devices

Abstract

Background: The rate of lead extraction has steadily increased alongside the extensive use of cardiovascular implantable electronic devices. Data on the complications and safety of this challenging procedure are limited. We investigated in-hospital and midterm outcomes following lead extraction.

Methods: Data were retrieved from 51 patients who underwent pacemaker/defibrillator lead extraction procedures at Tehran Heart Center between 2016 and 2021. The procedural success rate, patients’ demographic characteristics, and in-hospital and midterm procedure-related complications were investigated.

Results: Fifty-one patients were enrolled, including 44 men (86.3%). A total of 109 leads were extracted, with a 90.2% complete procedural success rate. In-hospital death occurred in 4 patients (7.8%): 1 patient (1.9%) died from pneumonia, 1 (1.9%) from septic shock, and 2 (3.9%) from septic shock besides heparin‐induced thrombocytopenia. Adverse events in 3 patients (5.8%) were directly related to the procedure: 1 patient (1.9%) suffered lung laceration and hemorrhage, 1 (1.9%) sustained subclavian injury, and 1 (1.9%) developed tamponade. Neither reinfection nor rehospitalization was observed during follow-up.

Conclusion: Lead extraction can be considered a highly successful procedure with a low rate of death-related events and complications.