Differences in laser lead extraction of infected vs. non-infected leads
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Differences in laser lead extraction of infected vs. non-infected leads. / Pecha, Simon; Castro, Liesa; Vogler, Julia; Linder, Matthias; Gosau, Nils; Willems, Stephan; Reichenspurner, Hermann; Hakmi, Samer.
In: HEART VESSELS, Vol. 33, No. 10, 10.2018, p. 1245-1250.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Differences in laser lead extraction of infected vs. non-infected leads
AU - Pecha, Simon
AU - Castro, Liesa
AU - Vogler, Julia
AU - Linder, Matthias
AU - Gosau, Nils
AU - Willems, Stephan
AU - Reichenspurner, Hermann
AU - Hakmi, Samer
PY - 2018/10
Y1 - 2018/10
N2 - We investigated the effect of systemic infection or lead endocarditis on the complexity and the success of laser lead extraction (LLE) procedures. Medical records of all patients undergoing LLE between January 2012 and March 2017 were screened with regard to information on systemic infection or lead endocarditis. We treated 184 patients using high-frequency 80 Hz laser sheaths in patients with lead implant duration of ≥ 12 months. Indications for lead extraction were systemic infection and lead endocarditis in 52 cases (28.3%), local infection in 74 cases (40.2%), lead dysfunction in 37 cases (20.1%) and other indications in 21 cases (11.4%). 386 leads were scheduled for LLE: 235 (60.9%) pacing, 105 (27.2%) ICD and 46 (11.9%) CS leads. The mean time from initial lead implantation (systemic infection 96.8 ± 74.7 months vs. 102.1 ± 82.6 non-infected: months; p = 0.4155) and ratio of ICD leads (26.8 vs. 27.4%; p = 0.3411) did not differ significantly between the two groups. Complete procedural success was significantly higher in the systemic infection group (100 vs. 94.7%; p = 0.0077). The mean laser treatment (60.2 ± 48.7 vs. 72.4 ± 61.5 s; p = 0.2038) was numerically lower in the infection group, while fluoroscopy time (9.3 ± 7.6 vs. 12.8 ± 10.3 min; p = 0.0275) was significantly lower in this group. Minor and major complications were low in both groups and did not reveal any statistically significant difference (infected group: one minor complication; pocket hematoma, non-infected: three major complications; emergent sternotomy due to pericardial tamponade). No extraction related mortality was observed. The presence of systemic infection or lead endocarditis in LLE procedures allows for higher complete procedural success. When compared with LLE of non-infected leads, the infected leads require less laser and fluoroscopy times. Due to the scarcity of minor and major complications in general, no statistical significance was found in that regard.
AB - We investigated the effect of systemic infection or lead endocarditis on the complexity and the success of laser lead extraction (LLE) procedures. Medical records of all patients undergoing LLE between January 2012 and March 2017 were screened with regard to information on systemic infection or lead endocarditis. We treated 184 patients using high-frequency 80 Hz laser sheaths in patients with lead implant duration of ≥ 12 months. Indications for lead extraction were systemic infection and lead endocarditis in 52 cases (28.3%), local infection in 74 cases (40.2%), lead dysfunction in 37 cases (20.1%) and other indications in 21 cases (11.4%). 386 leads were scheduled for LLE: 235 (60.9%) pacing, 105 (27.2%) ICD and 46 (11.9%) CS leads. The mean time from initial lead implantation (systemic infection 96.8 ± 74.7 months vs. 102.1 ± 82.6 non-infected: months; p = 0.4155) and ratio of ICD leads (26.8 vs. 27.4%; p = 0.3411) did not differ significantly between the two groups. Complete procedural success was significantly higher in the systemic infection group (100 vs. 94.7%; p = 0.0077). The mean laser treatment (60.2 ± 48.7 vs. 72.4 ± 61.5 s; p = 0.2038) was numerically lower in the infection group, while fluoroscopy time (9.3 ± 7.6 vs. 12.8 ± 10.3 min; p = 0.0275) was significantly lower in this group. Minor and major complications were low in both groups and did not reveal any statistically significant difference (infected group: one minor complication; pocket hematoma, non-infected: three major complications; emergent sternotomy due to pericardial tamponade). No extraction related mortality was observed. The presence of systemic infection or lead endocarditis in LLE procedures allows for higher complete procedural success. When compared with LLE of non-infected leads, the infected leads require less laser and fluoroscopy times. Due to the scarcity of minor and major complications in general, no statistical significance was found in that regard.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Defibrillators, Implantable/adverse effects
KW - Device Removal/methods
KW - Endocarditis/etiology
KW - Equipment Failure
KW - Female
KW - Follow-Up Studies
KW - Germany/epidemiology
KW - Humans
KW - Incidence
KW - Laser Therapy/methods
KW - Lasers, Excimer/therapeutic use
KW - Male
KW - Middle Aged
KW - Pacemaker, Artificial/adverse effects
KW - Postoperative Complications/diagnosis
KW - Retrospective Studies
KW - Treatment Outcome
KW - Young Adult
U2 - 10.1007/s00380-018-1162-0
DO - 10.1007/s00380-018-1162-0
M3 - SCORING: Journal article
C2 - 29623393
VL - 33
SP - 1245
EP - 1250
JO - HEART VESSELS
JF - HEART VESSELS
SN - 0910-8327
IS - 10
ER -
