Arrhythmias & electrophysiologyCohort study
Extraction outcomes of implantable cardioverter-defibrillator leads vary by manufacturer and model family
- Prospective registry cohort study
- single-centre
- consecutive patients
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
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:10.1093/europace/euad345
Summarised from the published abstract; every number is checked against it