Arrhythmias & electrophysiologyCohort study
Lead Extraction and Mortality Among Patients With Cardiac Implanted Electronic Device Infection
- Retrospective cohort study
- nationwide
- time-varying multivariable Cox regression
- Mean (SD) follow-up 4.6 (2.9) years after implantation
Authors' conclusion
In this study, a minority of patients with CIED infection underwent extraction. Extraction was associated with a lower risk of death compared with no extraction.
Study context
- Population
- Fee-for-service Medicare Part D beneficiaries with de novo cardiovascular implantable electronic device (CIED) implantation, 2006–2019; CIED infection >1 year after implantation11,304 with CIED infection
- Participants
- 1,065,549 beneficiaries
- Exposure
- Lead extraction vs no extraction in CIED infection
- Any extractionn = 2,102
- Extraction within 6 daysn = 1,511
- Extraction days 7–30n = 591
- No extractionn = 9,202reference
- Outcome
- Device infection, device extraction and all-cause mortality
Main finding
As reported in the abstract
All-cause mortality
Each group vs no extractionAdjusted hazard ratio (95% CI)P value
Any extraction
0.82(0.74–0.90)
P < 0.001Extraction within 6 days
0.69(0.61–0.78)
P < 0.001- CIED infection
- 11 304 (1.1%)
- Extraction within 30 days of diagnosis
- 2102 (18.6%)
- 1-year survival after infection
- 68.3%
Observational data: associations, not effects.
Further findings
Time from implantation to infection
- Mean (SD) years after implantation
- 3.7 (2.4)
Original publication
Lead Extraction and Mortality Among Patients With Cardiac Implanted Electronic Device Infection. JAMA Cardiol. Published 1 December 2023. doi:10.1001/jamacardio.2023.3379
Summarised from the published abstract; every number is checked against it