To abandon or not to abandon: Late consequences of pacing and ICD lead abandonment

Introduction The increasing number of cardiac implantable electronic device complications represents a current problem. Abandoned leads are difficult to manage, even because indications to transvenous lead extraction (TLE) cannot be generalized. The aim of the study was to assess the late consequenc...

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Published in:Pacing and clinical electrophysiology 2019-07, Vol.42 (7), p.1006-1017
Main Authors: Jacheć, Wojciech, Polewczyk, Anna, Segreti, Luca, Bongiorni, Maria Grazia, Kutarski, Andrzej
Format: Article
Language:English
Subjects:
abandoned lead
Abrasion
complications rate
functional lead
long‐term survival
Occlusion
Regurgitation
transvenous lead extraction
Tricuspid valve
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cited_by cdi_FETCH-LOGICAL-c3575-17c083ec7483ded5fbbc24761b66de483d37df89970bba8c6b7bbf04697c69943
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container_title Pacing and clinical electrophysiology
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creator Jacheć, Wojciech
Polewczyk, Anna
Segreti, Luca
Bongiorni, Maria Grazia
Kutarski, Andrzej
description Introduction The increasing number of cardiac implantable electronic device complications represents a current problem. Abandoned leads are difficult to manage, even because indications to transvenous lead extraction (TLE) cannot be generalized. The aim of the study was to assess the late consequences of previous abandoned leads. Methods We did a retrospective analysis of clinical data from 3,810 patients undergoing TLE in two high‐volume centers (Poland and Italy) in the years 2006–2017. In order to evaluate the effects of lead abandonment, the patients were divided into a group of 582 (15.3%) subjects with abandoned leads (AL) and a group of 3,228 (84.7%) subjects with functional leads (FL). Results Infective indications to TLE were predominant in the AL group (61.34% vs 43.4%; P 
doi_str_mv 10.1111/pace.13715
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Abandoned leads are difficult to manage, even because indications to transvenous lead extraction (TLE) cannot be generalized. The aim of the study was to assess the late consequences of previous abandoned leads. Methods We did a retrospective analysis of clinical data from 3,810 patients undergoing TLE in two high‐volume centers (Poland and Italy) in the years 2006–2017. In order to evaluate the effects of lead abandonment, the patients were divided into a group of 582 (15.3%) subjects with abandoned leads (AL) and a group of 3,228 (84.7%) subjects with functional leads (FL). Results Infective indications to TLE were predominant in the AL group (61.34% vs 43.4%; P &lt; 0.001). AL was associated with a higher number of leads per patient, longer lead dwell times, more frequent venous occlusion, higher probability of intracardiac lead abrasion, and tricuspid regurgitation (P &lt; 0.001 for all factors). The presence of AL was connected with more frequent technical complications of TLE (odds ratio [OR] 1.617; confidence interval [CI] 1.412–1.852; P = 0.000), lower procedural success rate (OR 0.270; CI 0.199–0.363; P = 0.000), and with higher mortality rate during 3.518 years of follow‐up [hazard ratio 1.286; 95% CI (1.062–1.558), P = 0.010]. Conclusions Presence of previously abandoned leads was associated with the risk of device infections, technical problems during subsequent lead extraction, dysfunction of tricuspid valve, and worse long‐term outcomes.</description><identifier>ISSN: 0147-8389</identifier><identifier>EISSN: 1540-8159</identifier><identifier>DOI: 10.1111/pace.13715</identifier><identifier>PMID: 31046136</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>abandoned lead ; Abrasion ; complications rate ; functional lead ; long‐term survival ; Occlusion ; Regurgitation ; transvenous lead extraction ; Tricuspid valve</subject><ispartof>Pacing and clinical electrophysiology, 2019-07, Vol.42 (7), p.1006-1017</ispartof><rights>2019 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3575-17c083ec7483ded5fbbc24761b66de483d37df89970bba8c6b7bbf04697c69943</citedby><cites>FETCH-LOGICAL-c3575-17c083ec7483ded5fbbc24761b66de483d37df89970bba8c6b7bbf04697c69943</cites><orcidid>0000-0002-6632-6551 ; 0000-0002-1091-9788</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31046136$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jacheć, Wojciech</creatorcontrib><creatorcontrib>Polewczyk, Anna</creatorcontrib><creatorcontrib>Segreti, Luca</creatorcontrib><creatorcontrib>Bongiorni, Maria Grazia</creatorcontrib><creatorcontrib>Kutarski, Andrzej</creatorcontrib><title>To abandon or not to abandon: Late consequences of pacing and ICD lead abandonment</title><title>Pacing and clinical electrophysiology</title><addtitle>Pacing Clin Electrophysiol</addtitle><description>Introduction The increasing number of cardiac implantable electronic device complications represents a current problem. Abandoned leads are difficult to manage, even because indications to transvenous lead extraction (TLE) cannot be generalized. The aim of the study was to assess the late consequences of previous abandoned leads. Methods We did a retrospective analysis of clinical data from 3,810 patients undergoing TLE in two high‐volume centers (Poland and Italy) in the years 2006–2017. In order to evaluate the effects of lead abandonment, the patients were divided into a group of 582 (15.3%) subjects with abandoned leads (AL) and a group of 3,228 (84.7%) subjects with functional leads (FL). Results Infective indications to TLE were predominant in the AL group (61.34% vs 43.4%; P &lt; 0.001). AL was associated with a higher number of leads per patient, longer lead dwell times, more frequent venous occlusion, higher probability of intracardiac lead abrasion, and tricuspid regurgitation (P &lt; 0.001 for all factors). The presence of AL was connected with more frequent technical complications of TLE (odds ratio [OR] 1.617; confidence interval [CI] 1.412–1.852; P = 0.000), lower procedural success rate (OR 0.270; CI 0.199–0.363; P = 0.000), and with higher mortality rate during 3.518 years of follow‐up [hazard ratio 1.286; 95% CI (1.062–1.558), P = 0.010]. Conclusions Presence of previously abandoned leads was associated with the risk of device infections, technical problems during subsequent lead extraction, dysfunction of tricuspid valve, and worse long‐term outcomes.</description><subject>abandoned lead</subject><subject>Abrasion</subject><subject>complications rate</subject><subject>functional lead</subject><subject>long‐term survival</subject><subject>Occlusion</subject><subject>Regurgitation</subject><subject>transvenous lead extraction</subject><subject>Tricuspid valve</subject><issn>0147-8389</issn><issn>1540-8159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kEFLwzAYhoMobk4v_gAJeBGhmixNk3gbdepgoMg8lyRNpaNNZtMi-_emdtvBg7l88PF8b14eAC4xusPh3W-kNneYMEyPwBjTGEUcU3EMxgjHLOKEixE4836NEEpQTE_BiGAUJ5gkY_C-clAqaXNnoWugdS1sD5sHuJStgdpZb746Y7Xx0BUw_FfaTxgQuEgfYWVkvr-ojW3PwUkhK28udnMCPp7mq_QlWr4-L9LZMtKEMhphphEnRrOYk9zktFBKT2OWYJUkuemXhOUFF4IhpSTXiWJKFaG3YDoRIiYTcDPkbhoX2vk2q0uvTVVJa1zns-kUh2uBeI9e_0HXrmtsaBcoShANNligbgdKN877xhTZpilr2WwzjLLedNabzn5NB_hqF9mp2uQHdK82AHgAvsvKbP-Jyt5m6XwI_QFStYZ4</recordid><startdate>201907</startdate><enddate>201907</enddate><creator>Jacheć, Wojciech</creator><creator>Polewczyk, Anna</creator><creator>Segreti, Luca</creator><creator>Bongiorni, Maria Grazia</creator><creator>Kutarski, Andrzej</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6632-6551</orcidid><orcidid>https://orcid.org/0000-0002-1091-9788</orcidid></search><sort><creationdate>201907</creationdate><title>To abandon or not to abandon: Late consequences of pacing and ICD lead abandonment</title><author>Jacheć, Wojciech ; Polewczyk, Anna ; Segreti, Luca ; Bongiorni, Maria Grazia ; Kutarski, Andrzej</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3575-17c083ec7483ded5fbbc24761b66de483d37df89970bba8c6b7bbf04697c69943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>abandoned lead</topic><topic>Abrasion</topic><topic>complications rate</topic><topic>functional lead</topic><topic>long‐term survival</topic><topic>Occlusion</topic><topic>Regurgitation</topic><topic>transvenous lead extraction</topic><topic>Tricuspid valve</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jacheć, Wojciech</creatorcontrib><creatorcontrib>Polewczyk, Anna</creatorcontrib><creatorcontrib>Segreti, Luca</creatorcontrib><creatorcontrib>Bongiorni, Maria Grazia</creatorcontrib><creatorcontrib>Kutarski, Andrzej</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pacing and clinical electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jacheć, Wojciech</au><au>Polewczyk, Anna</au><au>Segreti, Luca</au><au>Bongiorni, Maria Grazia</au><au>Kutarski, Andrzej</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>To abandon or not to abandon: Late consequences of pacing and ICD lead abandonment</atitle><jtitle>Pacing and clinical electrophysiology</jtitle><addtitle>Pacing Clin Electrophysiol</addtitle><date>2019-07</date><risdate>2019</risdate><volume>42</volume><issue>7</issue><spage>1006</spage><epage>1017</epage><pages>1006-1017</pages><issn>0147-8389</issn><eissn>1540-8159</eissn><abstract>Introduction The increasing number of cardiac implantable electronic device complications represents a current problem. Abandoned leads are difficult to manage, even because indications to transvenous lead extraction (TLE) cannot be generalized. The aim of the study was to assess the late consequences of previous abandoned leads. Methods We did a retrospective analysis of clinical data from 3,810 patients undergoing TLE in two high‐volume centers (Poland and Italy) in the years 2006–2017. In order to evaluate the effects of lead abandonment, the patients were divided into a group of 582 (15.3%) subjects with abandoned leads (AL) and a group of 3,228 (84.7%) subjects with functional leads (FL). Results Infective indications to TLE were predominant in the AL group (61.34% vs 43.4%; P &lt; 0.001). AL was associated with a higher number of leads per patient, longer lead dwell times, more frequent venous occlusion, higher probability of intracardiac lead abrasion, and tricuspid regurgitation (P &lt; 0.001 for all factors). The presence of AL was connected with more frequent technical complications of TLE (odds ratio [OR] 1.617; confidence interval [CI] 1.412–1.852; P = 0.000), lower procedural success rate (OR 0.270; CI 0.199–0.363; P = 0.000), and with higher mortality rate during 3.518 years of follow‐up [hazard ratio 1.286; 95% CI (1.062–1.558), P = 0.010]. Conclusions Presence of previously abandoned leads was associated with the risk of device infections, technical problems during subsequent lead extraction, dysfunction of tricuspid valve, and worse long‐term outcomes.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31046136</pmid><doi>10.1111/pace.13715</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-6632-6551</orcidid><orcidid>https://orcid.org/0000-0002-1091-9788</orcidid></addata></record>
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subjects abandoned lead
Abrasion
complications rate
functional lead
long‐term survival
Occlusion
Regurgitation
transvenous lead extraction
Tricuspid valve
title To abandon or not to abandon: Late consequences of pacing and ICD lead abandonment
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