Prolonged lead dwell time and lead burden predict bailout transfemoral lead extraction

• DOI: 10.1111/pace.13791
• Publication Date: 2019-08-21T12:19:11Z
• Authors: Justin Gould; Baldeep.S. Sidhu; Bradley Porter; Benjamin. J. Sien...; Thomas Teall; Steven.E. Williams; Anoop Shetty; Paolo Bosco; Christopher Blauth; Jaswinder Gill; Christopher. A. R...
• Keywords: Lead (geology); Demographics; Femoral vein

Abstract Background Transvenous lead extraction (TLE) may be performed by superior approach using the original implant vein or via a femoral approach; however, limited comparative data exists. We compare outcomes between versus nonfemoral TLE approaches and determine predictors of bailout transfemoral in patients undergoing initial approach. Methods All consecutive TLEs October 2000 March 2018 were prospectively collected ( n = 1052). Patients dichotomized into 118) 934) groups. Results Demographics balanced vs group had significantly higher mean dwell times (11.6 ± 9.7 6.6 years, P < .001), number leads extracted (2.7 1.3 2.0 1.0, 30‐day procedure related major complications (including deaths) (8.5% 1.1%, .001) emergency thoracotomy rates (4.2% 0.7%, .007). All‐cause mortality similar groups (3.4% 2.0%, .315). Prolonged time increased predictive at multivariable analysis. Conclusion Femoral is associated with risk but not all‐cause mortality. are independent for extraction. Such should considered high high‐volume centers experience multiple techniques including