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P3138Age based outcomes after implantable cardioverter-defibrillator extraction
Journal article   Peer reviewed

P3138Age based outcomes after implantable cardioverter-defibrillator extraction

P Sharedalal, N S Shah, A C Cubberley, H S Saltzman, S K Kutalek and Steven P Kutalek
European heart journal, v 40(Supplement_1)
01 Oct 2019
DOI: https://doi.org/10.1093/eurheartj/ehz745.0213

Abstract

Abstract Background There are growing numbers of defibrillator implantations for prevention of sudden cardiac death. As such, there has been a concomitant need for lead extraction. This procedure is often indicated in the setting of device or systemic infection, device upgrade, lead malfunction or elective extraction in cases of abandoned leads. Lead Extraction is associated with increased morbidity and mortality. The comparative safety and effectiveness of lead extraction in various age groups has not been well evaluated. Purpose The average age of patients undergoing lead extraction in our single center database is (65.5±15.9). There are lack of studies on age associated outcomes with lead extraction. We intend to evaluate differences in major in minor adverse outcomes in patients undergoing lead extraction stratified by age. Methods We identified 1,297 patients who underwent lead extraction between January 2003 and April 2016 at a major metropolitan center and evaluated procedural outcomes stratified by age. Age groups were stratified as <55, 55–64, 65–74, 75–84, and >85 years old. Baseline characteristics including history of coronary artery bypass graft (CABG), hypertension (HTN), congestive heart failure (CHF), hyperlipidemia (HLD), diabetes mellitus (DM) and coronary artery disease (CAD) were evaluated using chi-squared analysis. Adverse events were identified as major complications (death, cardiac arrest, cardiac perforation, coronary venous dissection, pericardial tamponade, or urgent cardiac surgery), and minor complications (coronary sinus dissection, pneumothorax, pocket bleeding requiring drainage, worsening tricuspid valve function, vegetation embolization, venous thrombosis, requirement of blood transfusion or lead migration). Subgroups for age were also analyzed using chi squared analysis to prevent type 1 error. Results There was no statistically significant difference in overall major and minor complications amongst different age groups (P>0.05). An overall statistically significant difference was noted in baseline characteristics of CABG, HTN, HLD, DM, and CAD (P<0.05). Within each age subgroup, no statistically significant difference was noted for major or minor complications post lead extraction (P>0.05). Conclusion This study shows lead extraction can be performed safely in patients of all age groups without significant overall risk of major or minor complications. Acknowledgement/Funding None

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