Long-term survival following transvenous lead extraction: importance of indication and comorbidities

Funding Acknowledgements Type of funding sources: None. Background/Introduction: The significant rise in cardiac implantable electronic devices (CIED) has been paralleled by an increase in the number of procedures required for the removal of such devices and their associated leads. High procedural success rates with low rates of major in hospital complications is well recognised. Longer term mortality following transvenous lead extraction (TLE) is less well characterised. Long term outcomes are important as they should inform the decision making and consent process, especially in non-infected cases where there may not be a class I indication for lead removal. Purpose The purpose of this study was to evaluate the factors influencing survival in patients undergoing TLE depending on extraction indication. Methods Clinical data from consecutive patients undergoing TLE in the reference centre between the years 2000 to 2019 were prospectively collected. Only patients surviving to discharge were included. The total cohort was divided into groups depending on whether there was an infective or non-infective indication for TLE. We evaluated the association of demographic, clinical, device related and procedure-related factors on mortality. Results A total of 1151 patients were included in the analysis. 632 (54.9%) and 519 patients (45.1%) were for infective and non-infective indications respectively. Analysis of long-term outcomes on the total cohort (mean 66-month follow-up) revealed a mortality of 34.1% (392 deaths). A higher proportion of patients died in the infection vs the non-infection group (38.6% vs 28.5%, p Conclusion Long-term mortality for patients undergoing TLE remains high. Consensus guidelines recommend evaluating risk for major complications when determining whether to proceed with TLE. This study suggests assessing longer-term outcomes when considering TLE, particularly for non-infective indications. Abstract Figure.