Arrhythmias & electrophysiology
Age-stratified outcomes of transvenous lead extraction: A 5090-patient experience from the ExTRACT registry
Authors' conclusion
In a high-volume center, TLE is safe and highly effective across all age groups, yielding similar outcomes, save for an increased risk of hemothorax in patients ≥85 years. These findings support age-neutral referral when clinically indicated.
Study context
- Population
- Patients who underwent transvenous lead extraction (TLE) between August 1996 and 2022 at the Cleveland Clinicpatients who underwent TLE
- Participants
- 5,090 patients
- Exposure
- Baseline characteristics and procedural outcomes were compared across 4 age groups; age as a predictor of procedural complications
- Younger adultsn = 2,345
- Youngest oldn = 1,430
- Middle oldn = 1,056
- Oldest oldn = 259
- Outcome
- Complete procedural success
Methodological detailsthe largest TLE registry to date, high-volume center, Multivariable logistic regression
- The largest TLE registry to date
- High-volume center
- Multivariable logistic regression
Main finding
As reported in the abstract
P = 0.035
- Complete procedural success exceeded 95% in all groups
- 95%
Observational data: associations, not effects.
Further findings
| Outcome | Younger adults | Oldest old | P value |
|---|---|---|---|
| Infection as extraction indicationOldest old vs younger adults | 31% | 75% | P < 0.001 |
Safety
Hemothorax
| Odds ratio (95% CI) | P value | ||
|---|---|---|---|
| Oldest oldIncreased in the ≥85 group; incidence remained <1% | 11.88 (1.50–68.45) | P = 0.008 | |
| 0.050.21520Odds ratio (log scale) |
| Outcome | Younger adults | Oldest old | P value |
|---|---|---|---|
| Major complicationOldest old vs younger adults | 2.8% | 3.5% | P = 0.517 |
| In-laboratory mortalityOldest old vs younger adults | 0.13% | 0.77% | P = 0.175 |
Complications including sternotomy, superior vena cava/right atrial tear, or death
- No significant association between age and complications (multivariable analysis)
Original publication
Age-stratified outcomes of transvenous lead extraction: A 5090-patient experience from the ExTRACT registry. Heart Rhythm. Published 8 September 2025. doi:10.
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