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Large, single-center experience in transvenous coronary sinus lead extraction: procedural outcomes and predictors for mechanical dilatation.
- Source :
-
Pacing and clinical electrophysiology : PACE [Pacing Clin Electrophysiol] 2012 Feb; Vol. 35 (2), pp. 215-22. Date of Electronic Publication: 2011 Dec 02. - Publication Year :
- 2012
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Abstract
- Background: The aim of this study was to evaluate procedural outcomes of coronary sinus (CS) lead extraction, focusing on predictors and need for mechanical dilatation (MD) in the event that manual traction (MT) is ineffective.<br />Methods: The study assessed results in 145 consecutive patients (age 69 ± 10 years; 121 men)--a total of 147 CS pacing leads--who underwent transvenous CS lead removal between January 2000 and March 2010.<br />Results: All leads but one (99%) (implantation time 29 ± 25 months) were successfully removed. MT was effective in 103 (70%), and MD was necessary in the remaining 44 (30%) procedures. In multivariate analyses, unipolar design (odds ratio [OR] 3.22, 95% confidence interval [CI] 1.43-7.7; P = 0.005) and noninfective indication (OR 4.8, 95% CI 1.8-13, P = 0.002) were independent predictors for MD (P < 0.0001), with a predictive trend for prior cardiac surgery (OR 2.2, 95% CI 0.98-5.26; P = 0.06). Five (3.4%) complex procedures required a transfemoral vein approach (TFA) or repeat procedure. No deaths occurred, and there was one major complication (0.7%), cardiac tamponade, after MT. No complication predictors were identified.<br />Conclusions: CS leads were safely and effectively removed in nearly all patients, and 70% were removed with MT alone; 30% required MD. Preoperative predictors suggesting the need for MD or TFA were noninfective indication and unipolar lead design. Complications were rare, and there was no predictable pattern among MT or MD removal techniques.<br /> (©2011, The Authors. Journal compilation ©2012 Wiley Periodicals, Inc.)
- Subjects :
- Aged
Cardiovascular Surgical Procedures methods
Device Removal methods
Female
Humans
Italy epidemiology
Male
Prevalence
Survival Analysis
Survival Rate
Treatment Outcome
Cardiovascular Surgical Procedures mortality
Coronary Sinus surgery
Device Removal mortality
Electrodes, Implanted statistics & numerical data
Pacemaker, Artificial statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1540-8159
- Volume :
- 35
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Pacing and clinical electrophysiology : PACE
- Publication Type :
- Academic Journal
- Accession number :
- 22132903
- Full Text :
- https://doi.org/10.1111/j.1540-8159.2011.03273.x