Long-term follow-up of abandoned transvenous defibrillator leads: a nationwide cohort study

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DOI

  • Anders Fyhn Elgaard, Aalborg University Hospital, Aalborg, Denmark.
  • ,
  • Jens Brock Johansen, Odense University Hospital, Odense, Denmark.
  • ,
  • Jens Cosedis Nielsen
  • Christian Gerdes
  • ,
  • Sam Riahi, Aalborg University Hospital, Aalborg, Denmark.
  • ,
  • Berit Thornvig Philbert, Rigshospitalet
  • ,
  • Jens Haarbo, Gentofte Hospital
  • ,
  • Thomas Maria Melchior, Zealand University Hospital
  • ,
  • Jacob Moesgaard Larsen, Aalborg University Hospital

AIMS : Commonly, a dysfunctional defibrillator lead is abandoned and a new lead is implanted. Long-term follow-up data on abandoned leads are sparse. We aimed to investigate the incidence and reasons for extraction of abandoned defibrillator leads in a nationwide cohort and to describe extraction procedure-related complications.

METHODS AND RESULTS : All abandoned transvenous defibrillator leads were identified in the Danish Pacemaker and ICD Register from 1991 to 2019. The event-free survival of abandoned defibrillator leads was studied, and medical records of patients with interventions on abandoned defibrillator leads were audited for procedure-related data. We identified 740 abandoned defibrillator leads. Meantime from implantation to abandonment was 7.2 ± 3.8 years with mean patient age at abandonment of 66.5 ± 13.7 years. During a mean follow-up after abandonment of 4.4 ± 3.1 years, 65 (8.8%) abandoned defibrillator leads were extracted. Most frequent reason for extraction was infection (pocket and systemic) in 41 (63%) patients. Procedural outcome after lead extraction was clinical success in 63 (97%) patients. Minor complications occurred in 3 (5%) patients, and major complications in 1 (2%) patient. No patient died from complication to the procedure during 30-day follow-up after extraction.

CONCLUSION : More than 90% of abandoned defibrillator leads do not need to be extracted during long-term follow-up. The most common indication for extraction is infection. Abandoned defibrillator leads can be extracted with high clinical success rate and low risk of major complications at high-volume centres.

Original languageEnglish
JournalEuropace
Volume22
Issue7
Pages (from-to)1097-1102
Number of pages6
ISSN1099-5129
DOIs
Publication statusPublished - Jul 2020

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