Analysis of Risk Factors for Major Complications of 1500 Transvenous Lead Extraction Procedures with Especial Attention to Tricuspid Valve Damage

Overview

Journal Int J Environ Res Public Health

Publisher MDPI

Specialties Environmental Health
Public Health

Date 2021 Sep 10

PMID 34501689

Citations 11

Authors

Lukasz Tulecki

Anna Polewczyk

Wojciech Jachec

Dorota Nowosielecka

Konrad Tomkow

Pawel Stefanczyk

Jaroslaw Kosior

Krzysztof Duda

Maciej Polewczyk

Andrzej Kutarski

Affiliations

Soon will be listed here.

Abstract

Background: Transvenous lead extraction (TLE) is a relatively safe procedure, but it may cause severe complications such as cardiac/vascular wall tear (CVWT) and tricuspid valve damage (TVD).

Methods: The risk factors for CVWT and TVD were examined based on an analysis of data of 1500 extraction procedures performed in two high-volume centers.

Results: The total number of major complications was 33 (2.2%) and included 22 (1.5%) CVWT and 12 (0.8%) TVD (with one case of combined complication). Patients with hemorrhagic complications were younger, more often women, less often presenting low left ventricular ejection fraction (LVEF) and those who received their first cardiac implantable electronic device (CIED) earlier than the control group. A typical patient with CVWT was a pacemaker carrier, having more leads (including abandoned leads and excessive loops) with long implant duration and a history of multiple CIED-related procedures. The risk factors for TVD were similar to those for CVWT, but the patients were older and received their CIED about nine years earlier. Any form of tissue scar and technical problems were much more common in the two groups of patients with major complications.

Conclusions: The risk factors for CVWT and TVD are similar, and the most important ones are related to long lead dwell time and its consequences for the heart (various forms of fibrotic scarring). The occurrence of procedural complications does not affect long-term survival in patients undergoing lead extraction.

Citing Articles

Complications of transvenous lead extraction-focus on tricuspid valve damage: a case report.

Jargielo A, Sterlinski M, Oreziak A, Pracon R, Kolsut P Eur Heart J Case Rep. 2025; 9(1):ytae695.

PMID: 39811751 PMC: 11732274. DOI: 10.1093/ehjcr/ytae695.

VDD Lead Extraction-Differences with Other Leads and Practical Tips in Management.

Kutarski A, Jachec W, Stefanczyk P, Polewczyk A, Kosior J, Nowosielecka D J Clin Med. 2024; 13(3).

PMID: 38337494 PMC: 10856487. DOI: 10.3390/jcm13030800.

Tricuspid valve disease and cardiac implantable electronic devices.

Andreas M, Burri H, Praz F, Soliman O, Badano L, Barreiro M Eur Heart J. 2023; 45(5):346-365.

PMID: 38096587 PMC: 10834167. DOI: 10.1093/eurheartj/ehad783.

2023 HRS/APHRS/LAHRS guideline on cardiac physiologic pacing for the avoidance and mitigation of heart failure.

Chung M, Patton K, Lau C, Dal Forno A, Al-Khatib S, Arora V J Arrhythm. 2023; 39(5):681-756.

PMID: 37799799 PMC: 10549836. DOI: 10.1002/joa3.12872.

Lead management in patients undergoing percutaneous tricuspid valve replacement or repair: a 'heart team' approach.

Gabriels J, Schaller R, Koss E, Rutkin B, Carrillo R, Epstein L Europace. 2023; 25(11).

PMID: 37772978 PMC: 10629975. DOI: 10.1093/europace/euad300.

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