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Transvenous Lead Extraction in Adult Patient with Leads Implanted in Childhood-Is That the Same Procedure as in Other Adult Patients?

Author

Listed:
  • Andrzej Kutarski

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

  • Wojciech Jacheć

    (2nd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Silesian Medical University, 41-800 Katowice, Poland)

  • Anna Polewczyk

    (Department of Physiology, Patophysiology and Clinical Immunology, Institute of Medical Sciences, Jan Kochanowski University, 25-369 Kielce, Poland
    Department of Cardiac Surgery, Świętokrzyskie Center of Cardiology, 25-736 Kielce, Poland)

  • Dorota Nowosielecka

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

  • Maria Miszczak-Knecht

    (Department of Cardiology, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland)

  • Monika Brzezinska

    (Department of Cardiology, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland)

  • Katarzyna Bieganowska

    (Department of Cardiology, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland)

Abstract

Background: Lead management in children and young adults is still a matter of debate. Methods: To assess the course of transvenous lead extraction (TLE) in adults with pacemakers implanted in childhood (CIP) we compared 98 CIP patients with a control group consisting of adults with pacemakers implanted in adulthood (AIP). Results: CIP patients differed from AIP patients with respect to indications for TLE and pacing history. CIP patients were four–eight times more likely to require second-line or advanced tools. Furthermore, CIP patients more often than AIP were prone to developing complications: major complications (MC) (any) 2.6 times; hemopericardium 3.2 times; severe tricuspid valve damage 4.4 times; need for rescue cardiac surgery 3.7 times. The rate of procedural success was 11% lower because of 4.8 times more common lead remnants and 3.1 times more frequent permanently disabling complications. Conclusions: Due to system-related risk factors TLE in CIP patients is more difficult and complex. TLE in CIP is associated with an increased risk of MC and incomplete lead removal. A conservative strategy of lead management, acceptable in very old patients seems to be less suitable in CIP because it creates a subpopulation of patients at high risk of major complications during TLE in the future.

Suggested Citation

  • Andrzej Kutarski & Wojciech Jacheć & Anna Polewczyk & Dorota Nowosielecka & Maria Miszczak-Knecht & Monika Brzezinska & Katarzyna Bieganowska, 2022. "Transvenous Lead Extraction in Adult Patient with Leads Implanted in Childhood-Is That the Same Procedure as in Other Adult Patients?," IJERPH, MDPI, vol. 19(21), pages 1-17, November.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:21:p:14594-:d:965288
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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.

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