High Mid‐Term Mortality Following Successful Lead Extraction for Infection

Abstract

True risk assessment for lead extraction patients is underestimated and may be related to the focus on the procedural risks, while the underlying illness and physiologic state may account for the excess mortality following a successful extraction. In most cases, the infected hardware contributed to the length and severity of the illness, and thus earlier consideration for extraction may be warranted.

Predictors of Long-Term Survival Following Transvenous Extraction of Defibrillator Leads

“…In aggregate, these studies are all consistent in demonstrating a significant risk of death at 1 year associated with CIED infection despite high rates of procedural success. Our study differs from prior studies in that all patients in our cohort underwent extraction of at least one ICD lead, whereas prior studies have included a mixture of patients undergoing extraction of both pacing devices and defibrillators . In the study by Maytin et al., there was a significant difference in the distribution of pacemakers versus defibrillators across the different indications for lead extraction.…”

“…In addition to procedural outcomes, several studies have assessed in‐hospital and short‐term (i.e., 30 days) survival following lead extraction . However, there are less long‐term data on outcomes of lead extraction and most studies which have assessed long‐term outcomes have focused on patients having extraction for cardiac implantable electronic device (CIED) infection, particularly with the goal of defining the impact of specific infectious characteristics on outcomes . Long‐term outcomes following lead extraction for noninfectious indications are less well‐described.…”

Long-Term Mortality After Transvenous Lead Extraction

“…Henrikson and colleagues 9 recently described midterm mortality rates among 67 patients undergoing TLE for infectious indications with an approximate even distribution of local and systemic infection. They observed a 30% mortality rate during the follow-up period (range, 6 -55 months).…”

“…4 -6 However, data regarding postprocedural and long-term mortality are limited. [7][8][9] This study examined the experience at a single high-volume extraction center regarding postprocedural and long-term mortality after TLE, in addition to evaluating potential correlates of mortality.…”

Techniques of Pacemaker Implantation and Removal

“…42,54 These late deaths probably relate to underlying co-morbidities as well as infectious complications in this chronically ill population. 42,54 These late deaths probably relate to underlying co-morbidities as well as infectious complications in this chronically ill population.…”