Arrhythmias & electrophysiology
Laser lead extraction of very old leads—Insights from the GermAn Laser Lead Extraction RegistrY (GALLERY)
Authors' conclusion
Patients undergoing TLE with older leads face increased procedural complexity and complication risks, requiring more frequent use of advanced extraction techniques and experiencing lower procedural success rates. However, lead age did not impact procedure-related or overall mortality.
Study context
- Population
- Patients undergoing transvenous lead extraction (TLE) in the GermAn Laser Lead Extraction RegistrY (GALLERY)
- Participants
- 858 vs 1,666
- Exposure
- TLE outcomes between patients with cardiac leads ≥10 years old (Group A) and those with leads <10 years old (Group B)
- Group An = 858
- Group Bn = 1,666
- Outcome
- Procedural duration
Main finding
As reported in the abstract
P < 0.001
Observational data: associations, not effects.
Further findings
Need for additional extraction tools · higher in Group A
P < 0.001
Procedural failure · significantly elevated in Group A
P = 0.002
Independent predictors of procedural failure
| Odds ratio (95% CI) | P value | ||
|---|---|---|---|
| Use of additional extraction tools | 4.4 (2.0–9.7) | P < 0.001 | |
| Body mass index ≥35 kg/m² | 4.4 (1.4–14.0) | P = 0.012 | |
| 0.050.21520Odds ratio (log scale) |
| Outcome | Group A | Group B |
|---|---|---|
| Baseline: age, indwelling leads, lead dwell time | ||
| Age | 70.4 ± 13.7 | 66.7 ± 13.7 |
| Indwelling leads | 2.5 ± 1.1 | 2.4 ± 1.0 |
| Lead dwell time | 13.45 [11.41-17.22] years | 6.0 [interquartile range (IQR): 4.0-7.8] years |
- Baseline: age, indwelling leads, lead dwell time: all P < .001
Safety
Overall complications · significantly elevated in Group A
P = 0.03
Major complications · significantly elevated in Group A
P = 0.005
Procedure-related mortality · no significant difference
P = 0.592
All-cause mortality · no significant difference
P = 0.711
Original publication
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