Safety and effectiveness of transvenous lead extraction in octogenarians

Gemma Pelargonio, Maria L. Narducci, Eleonora Russo, Michela Casella, Pasquale Santangeli, Robert Canby, Amin Al-Ahmad, Larry D. Price, Luigi Di Biase, Candice J. Kwark, Mark Harwood, Francesco Perna, Gianluigi Bencardino, Carolina Ierardi, Enrico M. Trecarichi, Enrica Santelli, Mario Tumbarello, Prasant Mohanty, Shane Bailey, John David BurkhardtFulvio Bellocci, Andrea Natale, Antonio Dello Russo

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Transvenous Lead Extraction. Introduction: As the population ages, the number of elderly patients with implantable cardiac devices referred for transvenous lead extraction will dramatically increase in Western countries. The safety and effectiveness of lead extraction in elderly patients has not been well evaluated. We report the safety and effectiveness of transvenous lead extraction in octogenarians. Methods and Results: From January 2005 to January 2011, we reviewed data from consecutive patients ≥ 80 years referred to our institutions for transvenous lead extraction because of cardiac device infection or lead malfunction. Clinical characteristics, procedural features, and periprocedural major and minor complications were compared between octogenarians and younger patients. Out of 849 patients undergoing lead extraction in the participating institutions during the study period, 150 (18%) patients were octogenarians (mean age 84 years; range 80-96; 64% males). A significantly higher percentage of octogenarians presented with chronic renal failure (55% vs 26%; P < 0.001), history of malignancy (22% vs 6%; P < 0.001), and chronic obstructive pulmonary disease (46% vs 19%; P < 0.001). Complete lead extraction rates were similar in the 2 age groups (97% in octogenarians vs 96% in patients <80 years; P = 0.39). Periprocedural death occurred in 2 (1.3%) patients ≥80 years and in 5 (0.72%) patients <80 years (P = 0.45 for comparison). No differences in terms of other periprocedural major and minor complications were found between the 2 age groups. Conclusion: Despite presenting with a significantly higher rate of comorbidities, transvenous lead extraction can be performed safely and successfully in octogenarians.

Original languageEnglish (US)
Pages (from-to)1103-1108
Number of pages6
JournalJournal of cardiovascular electrophysiology
Volume23
Issue number10
DOIs
StatePublished - Oct 2012
Externally publishedYes

Keywords

  • elderly
  • implantable cardioverter defibrillator
  • infection
  • lead extraction
  • octogenarians
  • pacemaker

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Pelargonio, G., Narducci, M. L., Russo, E., Casella, M., Santangeli, P., Canby, R., Al-Ahmad, A., Price, L. D., Biase, L. D., Kwark, C. J., Harwood, M., Perna, F., Bencardino, G., Ierardi, C., Trecarichi, E. M., Santelli, E., Tumbarello, M., Mohanty, P., Bailey, S., ... Russo, A. D. (2012). Safety and effectiveness of transvenous lead extraction in octogenarians. Journal of cardiovascular electrophysiology, 23(10), 1103-1108. https://doi.org/10.1111/j.1540-8167.2012.02372.x