Arrhythmias & electrophysiologyCohort study
Procedural Characteristics and Outcomes of Transvenous Lead Extraction in Patients With Prior Sternotomy
- Prospectively maintained registry
- single-centre
- multivariable logistic regression
- propensity score-matched cohort
Authors' conclusion
Despite exhibiting higher comorbidities, PS patients had fewer major complications during TLE, suggesting a protective effect. Still, the challenges of repeat sternotomy highlight the need for recognizing these patients as high-risk should complications occur.
Study context
- Population
- Patients undergoing transvenous lead extraction (TLE) at one center between 1996 and 2022patients undergoing TLE, 1,344 (27.7%) had a prior sternotomy
- Participants
- 4,846 patients
- Exposure
- Prior sternotomy (PS) vs No prior sternotomy
- PSn = 1,344
Main finding
As reported in the abstract
Baseline characteristics
- PS patients had a higher prevalence of comorbidities and an infectious indication for extraction
Observational data: associations, not effects.
Further findings
Procedural success
- Higher procedural success rates in PS patients
Safety
| Outcome | PS | No prior sternotomy | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| Major complications · multivariable analysis | 1.4% | 3.0% | 0.52 (0.30–0.89) | P = 0.016 | |
| Major cardiovascular injury · multivariable analysis | 0.54 (0.30–0.98) | P = 0.043 | |||
| 0.20.5125Odds ratio (log scale) |
Outcome not named in the abstract
Emergent rescue cardiac surgeries
- Major complications: unadjusted P = 0.001
- Major complications: findings persisted in a propensity score-matched cohort of 1,256 pairs
- Outcome not named in the abstract: P = 0.03
- Emergent rescue cardiac surgeries: P = 0.011
Original publication
Procedural Characteristics and Outcomes of Transvenous Lead Extraction in Patients With Prior Sternotomy. JACC Clin Electrophysiol. Published 5 March 2026. doi:10.1016/j.jacep.2026.01.039
Summarised from the published abstract; every number is checked against it