TRANSVENOUS LEAD EXTRACTION IN OCTOGENARIANS. SAFETY AND EFFECTIVENESS
A. Kutarski (1), K. Boczar (2), A. Zabek (2), M. Polewczyk (3)
(1) Dept of Cardiology Medical University of Lublin, Poland (2) Department of Electrocardiology, John Paul II Hospital, Krakow, Poland, (3) Student of Medical University of Warsaw, First Faculty of Medicine, Poland
Introduction: There is considerable controversy regarding safety of transvenous lead extraction (TLE) in elderly patients due to theirs potentially worse general condition, more concomitant diseases and more difficult sedation / analgesia and current experience is not so big.
Objective: The comparison of safety and feasibility of TLE in elderly and middle age pts. Methods: Using standard mechanical systems we have extracted ingrown PM/ICD leads from 1060 adult pts (21-70y) and in 192 octogenarians within the last 7 years. We compared effectiveness & complications of the TLE procedures in mentioned two groups of pts.
Results: .
Observations: There are more woman in octogenarians referred for TLE. In this group there are more pocket infections and less non-infective indications for TLE and ICD systems as well.
Conclusions: Ripe old age does not influence on TLE effectiveness. So TLE can be performed safely and successfully in octogenarians.
| Patient / procedure
|
21-79 y
|
80 and > y
|
P
|
| Number of patients |
1060 |
192 |
- |
| Patient’s age (SD) |
62,7±13,4 |
83,4±3,10 |
0,000001 |
| Sex (% of male patients) |
669 (63,1 %) |
105 (54,7%) |
0,0331 |
| Endocarditis |
189 (17,8%) |
31 (16,1%) |
0,6446 |
| Pocket infection |
259 (24,5%) |
71 (37,0%) |
0,0004 |
| Non-infective indications |
611 (57,7%) |
90 (46,9%) |
0,0072 |
| Number of leads before TLE (SD) |
2,01±0,81 |
2,06±0,77 |
0,4280 |
| VH therapy (ICD) lead extraction |
305 (28,8%) |
14 (7,3%) |
0,000001 |
| Leads body dwelling time (SD) |
83,5±63,0 |
76,4±56,8 |
0,1451 |
| Major complications |
16 (1,51%) |
3 (1,56%) |
0,7907 |
| Minor complications |
20 (1,88%) |
2 (1,00%) |
0,6019 |
| Full radiological success |
1002 (94,6%) |
187 (97,4%) |
0,1354 |
| Partial radiological success |
46 (4,34%) |
5 (2,6%) |
0,3571 |
| Operating room stay-in time (minutes) (SD) |
111,44±47,7 |
103,9±45,7 |
0,0776 |
