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Prognostic Value of Preoperative Echocardiographic Findings in Patients Undergoing Transvenous Lead Extraction

Author

Listed:
  • Dorota Nowosielecka

    (Department of Cardiology, The Pope John Paul II Province Hospital, 22-400 Zamość, Poland)

  • Wojciech Jacheć

    (2nd Department of Cardiology, Silesian Medical University, 40-055 Zabrze, Poland)

  • Anna Polewczyk

    (Department of Physiology, Pathophysiology and Clinical Immunology, Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
    Department of Cardiac Surgery, Świętokrzyskie Cardiology Center, 25-001 Kielce, Poland)

  • Łukasz Tułecki

    (Department of Cardiac Surgery, The Pope John Paul II Province Hospital, 22-400 Zamość, Poland)

  • Andrzej Kleinrok

    (Department of Cardiology, The Pope John Paul II Province Hospital, 22-400 Zamość, Poland
    Department of Physiotherapy, Medical College of University of Technology and Management, 35-225 Rzeszów, Poland)

  • Andrzej Kutarski

    (Department of Cardiology, Medical University, 20-059 Lublin, Poland)

Abstract

(1) Background: In patients referred for transvenous lead extraction (TLE) transesophageal echocardiography (TEE) often reveals abnormalities related to chronically indwelling endocardial leads. The purpose of this study was to determine whether the results of pre-operative TEE might influence the long-term prognosis. (2) Methods: We analyzed data from 936 TEE examinations performed at a high volume center in patients referred for TLE from 2015 to 2019. The follow-up was 566.2 ± 224.5 days. (3) Results: Multivariate analysis of TEE parameters showed that vegetations (HR = 2.631 [1.738–3.983]; p < 0.001) and tricuspid valve (TV) dysfunction unrelated to the endocardial lead (HR = 1.481 [1.261–1.740]; p < 0.001) were associated with increased risk for long-term mortality. Presence of fibrous tissue binding sites between the lead and the superior vena cava (SVC) and/or right atrium (RA) wall (HR = 0.285; p = 0.035), presence of penetration or perforation of the lead through the cardiac wall up to the epicardium (HR = 0.496; p = 0.035) and presence of excessive lead loops (HR = 0.528; p = 0.026) showed a better prognosis. After adjustment the statistical model with recognized poor prognosis factors only vegetations were confirmed as a risk factor (HR = 2.613; p = 0.039). A better prognosis was observed in patients with fibrous tissue binding sites between the lead and the superior vena cava (SVC) and/or right atrium (RA) wall (HR = 0.270; p = 0.040). (4) Conclusions: Non-modifiable factors may have a negative influence on long-term survival after TLE. Various forms of connective tissue overgrowth and abnormal course of the leads modifiable by TLE can be a factor of better prognosis after TLE.

Suggested Citation

  • Dorota Nowosielecka & Wojciech Jacheć & Anna Polewczyk & Łukasz Tułecki & Andrzej Kleinrok & Andrzej Kutarski, 2021. "Prognostic Value of Preoperative Echocardiographic Findings in Patients Undergoing Transvenous Lead Extraction," IJERPH, MDPI, vol. 18(4), pages 1-20, February.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:4:p:1862-:d:499348
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    Citations

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    Cited by:

    1. Paul-Mihai Boarescu & Iulia Diana Popa & Cătălin Aurelian Trifan & Adela Nicoleta Roşian & Ştefan Horia Roşian, 2022. "Practical Approaches to Transvenous Lead Extraction Procedures—Clinical Case Series," IJERPH, MDPI, vol. 20(1), pages 1-15, December.
    2. Dorota Nowosielecka & Wojciech Jacheć & Anna Polewczyk & Łukasz Tułecki & Paweł Stefańczyk & Andrzej Kutarski, 2022. "“Ghost”, a Well-Known but Not Fully Explained Echocardiographic Finding during Transvenous Lead Extraction: Clinical Significance," IJERPH, MDPI, vol. 19(19), pages 1-16, October.

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