Heart failure is associated with increased risk of all‐cause mortality after transvenous lead extraction: A systematic review and meta‐analysis

Abstract

BackgroundTransvenous lead extraction (TLE) is increasingly considered in cardiac implantable electronic device management. Heart failure (HF) might be associated with mortality risks after the TLE procedure. This study aims to assess mortality risk in HF patients undergoing TLE.MethodWe searched MEDLINE and Embase databases from inception to June 2022 to identify articles that included patients with and without HF who underwent TLE, which reported mortality in both groups. The pooled effect size was calculated with a random‐effects model and 95% CI to compare post‐TLE mortality between the two groups.ResultsEleven studies were included in the analysis. Each left ventricular ejection fraction (LVEF) increased by 1% was associated with reduced mortality by 2% (HR = 0.98, 95% CI: 0.97–0.99, I2 = 74.9%, p < .01). The presence of HF compared to those without HF was associated with higher mortality rates (OR: 3.04, 95% CI: 2.56–3.61, I2 = 0.0%, p < .531). There was a significant increase in the mortality rates in patients with New York Heart Association (NYHA) function class III (OR: 2.29, 95% CI: 1.29–4.06, I2 = 0.0%, p = .498) and NYHA IV (OR: 8.5, 95% CI: 2.98–24.3, I2 = 0.0%, p = .997).ConclusionsOur study found that post‐TLE mortality decreases by 2% as LVEF increases by 1%, also mortality is higher in patients with NYHA III and IV.

Holistic Approaches to Arrhythmia Management: Combining Medication, Ablation, and Device Interventions

“…Notably, electroanatomic mapping systems have become more sophisticated, enabling faster and more precise mapping of the cardiac chambers. Utilizing high-density mapping catheters, such as the Advisor HD Grid mapping catheter, improves spatial resolution and can shorten procedure times [ 23 ]. The development of contact force-sensing catheters is another significant development.…”

“…Collaboration among healthcare professionals allows for a comprehensive assessment of the patient's overall health. This can include evaluating the impact of arrhythmias on other organs and systems, such as the kidneys and lungs, to provide more tailored treatment plans [ 23 ].…”