Predictors of Percutaneous Lead Extraction Major Complications: A Tertiary Center Experience

Abstract

Background and Aim: Over the years, transvenous lead extraction (TLE) procedures (TLEP) have been increasing because of factors such as infection, loss of device function, and lead-related complications. This study aimed to evaluate the factors affecting major complications during TLEP. Materials and Methods: Between January 2011 and May 2023, patients who underwent TLE of cardiac implantable electronic devices were included in the study. The demographic and procedural features of all patients were evaluated according to major complications. Results: A total of 121 consecutive patients (192 leads) underwent TLEP. The mean age was 63 ± 17.3 years, and 76% were male. Most leads were active fixation leads (67%) and 74 procedures (61%) required an extraction device. The mean lead dwell time was 5.6 ± 5.2 years. Major complications were observed in 16 procedures (13.2%) and 5 of them (4.1%) resulted in exitus. When we compared the groups according to the major complication, the rates of chronic obstructive pulmonary disease (4 vs. 3; P = 0.020), existence of passive fixation leads (PFL) (24 vs. 9; P = 0.013), and device indication (P = 0.012) were higher in the complication group. Multivariate analysis revealed that only the presence of PFL was associated with major complications. (odds ratio 4.486, 95% confidence interval 1.365-14.748; P = 0.013) Conclusion: The present study showed that the presence of a PFL is a predictive factor for major complications.

Keywords

• percutaneous lead extraction
• transvenous lead extraction
• cardiac implantable electronic devices