Objective The aim of this study was to evaluate the incidence of venous stenosis and occlusion (VSO) in patients referred for transvenous lead extraction (TLE) with regard to the indications for this treatment and to analyse the influence of VSO on efficacy, complications and technical challenges of TLE procedures. Methods The material consists of 133 consecutive TLE procedure records. The contrast venography examination of the ipsilateral access vein was performed prior to the operation. The whole study population was divided into two subgroups, based on the presence (subgroup I) or absence (subgroup II) of VSO. Results Phlebography was performed in 133 patients with age ranging from 25.7 to 86.1 years, 44 female (33.1%). The VSO was confirmed in 48 (36.1%) patients - subgroup I. Most of the patients were referred to TLE due to non-infectious reasons (100 pts-75.2%). The absence of VSO was observed substantially more frequently in patients with diabetes (P = 0.02). Procedural success rate reached 93.3% in subgroup I and 98.8% in subgroup II (P = 0.1). There was no significant difference in the use of advanced tools and alternative access sites. Conclusion The presence of VSO can be expected in one third of patients referred for lead extraction. There is no association between indication for TLE (infected or noninfected lead extraction) and the incidence of VSO. Diabetes proved to have a protective effect on venous patency in the previously mentioned group. VSO does not influence the effectiveness, safety, and the use of additional tools during TLE procedures.

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Leads with polyurethane 80A insulation, unipolar construction, and those implanted via subclavian vein puncture exhibited the worst long-term performance.

The dominant indication to TLE procedures was lead dysfunction. Transvenous lead extraction has a high success rate and a low complication rate. Low BMI increased the complication rate.

In the very-long-term follow-up of DDD pacemaker patients, the parameters associated with survival were sex and baseline age at first implantation.

This patients cohort showed that there is an association between gender and indications to DDD pacing therapy. The rate of adverse events was similar in both genders. Women had a significantly longer duration of follow-up, despite markedly higher age at implantation.

BACKGROUND Pacemakers have become the standard of care in patients with severe bradycardia and conduction abnormalities. The survival and premature mortality can be assessed using the years of life lost (YLLs). AIMS The aim of the study was to analyze mortality trends over the period from 1999 to 2015 among patients implanted with a dual-chamber (DDD) pacemaker who were inhabitants of Małopolska Province. METHODS This was a retrospective study of records collected from consecutive patients who underwent de novo DDD pacemaker implantation at a single center between 1984 and 2014. Inclusion criteria were residence status in Małopolska Province at the latest follow-up visit and death between 1999 and 2015. The standard expected years of life lost per death was used to calculate YLLs. Time trends were evaluated with joinpoint models and presented as an average annual percentage change (AAPC). RESULTS Among a total of 3932 consecutive patients implanted with a DDD pacemaker, 1211 patients met the inclusion criteria. We noted an increase in the mean age at implant from 70 years in 1999 to 75.5 years in 2015 (AAPC, 0.6%; P <0.05), the number of years lived after DDD pacemaker implantation from 2.6 years to 8.2 years (AAPC, 7.4%; P <0.05), and the mean age at death from 72.6 years to 83.8 years (AAPC, 0.89%; P <0.05). Finally, we observed a reduction of the YLLs per death from 17.4 years in 1999 to 9 years in 2015 (AAPC,-4%; P <0.05). All trends were significant for both men and women. CONCLUSIONS In the 17-year follow-up, we showed significant changes in analyzed trends, in particular a reduction in the YLLs per death.

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