Efficacy and safety of transvenous lead extraction in the Chinese octogenarian patients

Abstract

Background: Managing elderly patients with infection or malfunction deriving from a cardiac implantable electronic device (CIED) may be challenging. We report the safety and effectiveness of transvenous lead extraction in Chinese octogenarian patients. Hypothesis: Transvenous lead extraction can be performed safely and successfully in the Chinese octogenarians. Methods: We retrospectively identified all patients who underwent TLE at our institution between March 2013 and January 2021. This population was divided into the following two groups based solely on age: octogenarians and non-octogenarians. These two groups were compared on the basis of several characteristics and clinical outcomes. Results: Consecutive 1106 patients were analyzed, including 184 (16.6%) octogenarians and 922(83.4%) non-octogenarians. The octogenarians presented more comorbidities. A total of 378 leads and 2004 leads were removed from the patients in the octogenarian group and non-octogenarian group, respectively. The mean lead implant duration was 6.1 ± 5.1 and 5.8 ± 4.6 years for octogenarians and non-octogenarians (p = 0.296). The majority of the patients in both groups underwent TLE through the femoral approach (67.5% vs 61.6%, p = 0.14). The complete procedure success rate was similar between the octogenarian and non-octogenarian group (96.7% vs.95.3%, p = 0.39). There were no differences with respect to the proportion of minor, major complications and deaths. Long-term mortality (median time 3.3 years) after TLE in octogenarians was significantly higher compared with younger individuals. Conclusions: At experienced centers, transvenous lead extraction can be performed safely in Chinese octogenarians with procedural success rate and complication rate comparable to younger individuals.