Arrhythmias & electrophysiology
Extraction outcomes of implantable cardioverter-defibrillator leads vary by manufacturer and model family
Authors' conclusion
Complete and safe ICD lead removal rate by TLE is extremely high but varied by manufacturer and lead family. Linox family lead and >10 years lead age were independent predictors of incomplete lead removal.
Study context
- Population
- Patients with implantable cardioverter-defibrillator (ICD) undergoing transvenous lead extraction (TLE), Cleveland Clinic Prospective TLE Registry, 2013–2022885 ICD leads
- Participants
- 810 patients
- Exposure
- ICD lead extraction outcomes by manufacturer and lead family
- Outcome
- Complete procedural success of ICD TLE
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
Complete procedural success, by manufacturer
- Complete ICD TLE success, leads (n = 860)
- 97.2%
- Complete ICD TLE success, patients (n = 794)
- 98.0%
- Difference across manufacturers
- P = 0.03
- Linox family leads, lowest success
- 89.7%
- Linox family vs others
- P = 0.02
Observational data: associations, not effects.
Further findings
Predictors of incomplete ICD lead removal (multivariable)
- ICD lead age > 10 years and Linox family lead
Predictors of all-cause mortality (multivariable) · within 30 days
- Lead extraction for infection, end-stage renal disease, higher NYHA functional class
Safety
Major complications
- Major complications
- 22 patients (2.7%)
- Multivariable predictors of major complications: ICD lead age > 15 years and longer lead extraction time
- Predictors of all-cause mortality within 30 days: lead extraction for infection, end-stage renal disease, higher NYHA class
Original publication
Extraction outcomes of implantable cardioverter-defibrillator leads vary by manufacturer and model family. Europace. Published 24 November 2023. doi:10.
Summarised from the published abstract; every number is checked against it