Risk score to assess mortality risk in patients undergoing transvenous lead extraction

Oszczygieł, Ewa; Kutarski, Andrzej; Oszczygiel, A; Mańkowska-Załuska, Beata; Chudzik, Michał; Wranicz, Jerzy Krzysztof; Cygankiewicz, Iwona

doi:10.1111/pace.13127

Cited by 19 publications

(17 citation statements)

References 15 publications

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“…Available scoring systems are based on a relatively small number of cases and incorporate various potential risk factors [1,[7][8][9][10]15,16]. Additionally, the early scales focused mainly on technical difficulties and factors influencing short-term mortality [7][8][9][10][11][12]. Only two existing scores estimate the risk of major complications during TLE.…”

Section: Discussionmentioning

confidence: 99%

“…With the increasing incidence of difficult lead extractions, appropriate procedure-related risk assessment is becoming more and more important. According to previous studies, the rate of major complications during a TLE ranges from 0.9% to 4.0% [2][3][4][5][6][7][8][9][10][11][12], including most often damage to the heart muscle or veins. The occurrence of major complications requires immediate surgical intervention, and for this reason, extraction procedures should ideally be performed in a hybrid operating room in the presence of cardiac surgical teams.…”

Section: Introductionmentioning

confidence: 99%

“…Until now, there has been no precise percentage score for estimating the risk of developing complications during and after a TLE. The currently available TLE risk stratification tools most often consider factors that impact the technical difficulty of the procedure [7,8] or periprocedural mortality [9,10]. This study presents for the first time a validated risk score derived from a large prospective database to predict the major complications of a TLE.…”

Section: Introductionmentioning

confidence: 99%

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Transvenous Lead Extraction SAFeTY Score for Risk Stratification and Proper Patient Selection for Removal Procedures Using Mechanical Tools

Jacheć

Polewczyk

Tomasik

et al. 2020

JCM

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Background: To ensure the safety and efficacy of the increasing number of transvenous lead extractions (TLEs), it is necessary to adequately assess the procedure-related risk. Methods: We analyzed potential clinical and procedural risk factors associated with 2049 TLE procedures. The TLEs were performed between 2006 and 2016 using only simple tools for lead extraction. Logistic regression analysis was used to develop a risk prediction scoring system for TLEs. Results: Multivariate analysis showed that the sum of lead dwell times, anemia, female gender, the number of procedures preceding TLE, and removal of leads implanted in patients under the age of 30 had a significant influence on the occurrence of major complications during a TLE. This information served as a basis for developing a predictive SAFeTY TLE score, where: S = sum of lead dwell times, A = anemia, Fe = female, T = treatment (previous procedures), Y = young patients, and TLE = transvenous lead extraction. In order to facilitate the use of the SAFeTY TLE Score, a simple calculator was constructed. Conclusion: The SAFeTY TLE score is easy to calculate and predicts the potential occurrence of procedure-related major complications. High-risk patients (scoring more than 10 on the SAFeTY TLE scale) must be treated at high-volume centers with surgical backup.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transvenous Lead Extraction SAFeTY Score for Risk Stratification and Proper Patient Selection for Removal Procedures Using Mechanical Tools

Jacheć

Polewczyk

Tomasik

et al. 2020

JCM

Self Cite

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“…Using lead age as the sole parameter, a previous study has suggested risk stratification, however, a prospective validation is lacking thus limiting widespread adoption . Similarly, several other risk stratification scores have been proposed . All these scores are based on the retrospective data.…”

Section: Discussionmentioning

confidence: 99%

“…11 Similarly, several other risk stratification scores have been proposed. [13][14][15] All these scores are based on the retrospective data. Except one, no risk score has been validated prospectively.…”

Section: Risk Stratification Prior To Les-a Historical Perspectivementioning

confidence: 99%

RIsk Stratification prior to lead Extraction and impact on major intraprocedural complications (RISE protocol)

Afzal

Daoud

Matre

et al. 2019

Cardiovasc electrophysiol

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Background An internal risk stratification algorithm was developed to decrease the risk of major adverse cardiac events (MACEs) during lead extractions (LEs). Objective To report upon the impact of a risk stratification algorithm (RISE [RIsk Stratification prior to lead Extraction] protocol) on outcomes of LEs in a high‐volume center. Methods A retrospective review of a prospectively maintained LEs database was performed to identify features associated with MACEs. On the basis of the retrospective data, the RISE protocol differentiated LEs procedures into “High” and “Low” risk for occurrence of MACEs. High‐risk LEs included dual‐coil defibrillator lead (≥3 years), pacemaker and single‐coil lead (≥5 years), and any StarFix coronary sinus lead. During the prospective evaluation of the RISE protocol, “High‐risk” LEs were performed in an operating room (OR) or hybrid laboratory with the cardiac anesthesiologist, OR nursing team, perfusionist in the room, and a cardiac surgeon on the premises. “Low‐risk” LEs were performed in the electrophysiology (EP) laboratory with anesthesia provided by EP nursing team. The preintervention (pre‐RISE) and postintervention (post‐RISE) group spanned 19 and 40 months and consisted of 449 (632 leads) and 751 patients (1055 leads), respectively. The primary outcome of MACEs in the two groups was compared. Results Protocol compliance was 100%. The primary outcome of MACEs occurred in 15 patients (3.34%) before and 12 (1.6%) after implementation of the RISE protocol (P = .04). Conclusion RISE identified a low‐risk group where minimal resources are needed and allowed for rapid intervention in the high‐risk group that reduced the consequences of MACEs.

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Follow-Up and Prognosis After System Removal for Cardiac Device Infection

Theuns

Yap

Szili-Török

2020

Infections of Cardiac Implantable Devices

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Risk score to assess mortality risk in patients undergoing transvenous lead extraction

Abstract: One-year mortality of patients undergoing TLE procedure can be predicted by using IKAR risk score.

Cited by 19 publications

References 15 publications

Transvenous Lead Extraction SAFeTY Score for Risk Stratification and Proper Patient Selection for Removal Procedures Using Mechanical Tools

Transvenous Lead Extraction SAFeTY Score for Risk Stratification and Proper Patient Selection for Removal Procedures Using Mechanical Tools

RIsk Stratification prior to lead Extraction and impact on major intraprocedural complications (RISE protocol)

Follow-Up and Prognosis After System Removal for Cardiac Device Infection

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