Academic Journal
Laser lead extraction of very old leads-Insights from the GermAn Laser Lead Extraction RegistrY (GALLERY).
| Τίτλος: | Laser lead extraction of very old leads-Insights from the GermAn Laser Lead Extraction RegistrY (GALLERY). |
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| Συγγραφείς: | Chung DU; Department of Cardiology and Critical Care Medicine, Heart and Vascular Center, Asklepios Klinik, St. Georg Hamburg, Germany; Semmelweis University Budapest, Asklepios Campus Hamburg, Hamburg, Germany. Electronic address: d.chung@asklepios.com., Burger H; Department of Cardiac Surgery, Kerckhoff Klinik, Bad Nauheim, Germany., Ghaffari N; Department of Cardiovascular Surgery, Helios Klinik Karlsruhe, Karlsruhe, Germany., Madej T; Department of Cardiac Surgery, University Heart Center Dresden, Dresden, Germany., Ziaukas V; Department of Cardiac Surgery, Schüchtermann-Klinik, Bad Rothenfelde, Germany., Reichenspurner H; Department of Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Centre for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Luebeck, Hamburg, Germany., Butter C; Department of Cardiology, Heart Centre Brandenburg Bernau and Faculty of Health Sciences Brandenburg, Brandenburg Medical School (MHB) Theodor Fontane, Bernau/Berlin, Germany., Willems S; Department of Cardiology and Critical Care Medicine, Heart and Vascular Center, Asklepios Klinik, St. Georg Hamburg, Germany; Semmelweis University Budapest, Asklepios Campus Hamburg, Hamburg, Germany; German Centre for Cardiovascular Research (DZHK), Partner site Hamburg/Kiel/Luebeck, Hamburg, Germany., Pecha S; Department of Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Hakmi S; Semmelweis University Budapest, Asklepios Campus Hamburg, Hamburg, Germany; Department of Cardiac Surgery, Heart and Vascular Center, Asklepios Klinik St. Georg, Hamburg. |
| Συλλογικό Έργο: | GALLERY Investigators |
| Πηγή: | Heart rhythm [Heart Rhythm] 2026 Jul; Vol. 23 (7), pp. 1616-1624. Date of Electronic Publication: 2025 Aug 05. |
| Τύπος έκδοσης: | Journal Article; Multicenter Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: United States NLM ID: 101200317 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1556-3871 (Electronic) Linking ISSN: 15475271 NLM ISO Abbreviation: Heart Rhythm Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, NY : Elsevier, c2004- |
| Ιατρικοί όροι (MeSH): | Device Lead Extraction*/methods , Device Lead Extraction*/adverse effects , Defibrillators, Implantable*/adverse effects , Pacemaker, Artificial*/adverse effects , Postoperative Complications*/epidemiology , Device Removal*/methods , Laser Therapy*/methods , Registries*, Germany/epidemiology ; Humans ; Retrospective Studies ; Female ; Male ; Aged ; Risk Factors ; Follow-Up Studies ; Equipment Failure |
| Περίληψη: | Background: Older pacemaker and defibrillator leads are established risk factors for complications during transvenous lead extraction (TLE); however, its impact on procedural outcomes remains clinically relevant. Objective: This study aimed to compare TLE outcomes between patients with cardiac leads ≥10 years old (Group A, n = 858) and those with leads <10 years old (Group B, n = 1666). Methods: This retrospective comparative analysis focused on baseline and lead characteristics, procedural outcomes, and identifying predictors of adverse events. Results: Group A patients were older (70.4 ± 13.7 vs 66.7 ± 13.7; P < .001), had more indwelling leads (2.5 ± 1.1 vs 2.4 ± 1.0; P < .001) and had longer lead dwell times (13.45 [11.41-17.22] and 6.0 [interquartile range (IQR): 4.0-7.8] years [P < .001]), than Group B patients. Procedural duration was longer (93.5 [IQR: 63-145] vs 75 [IQR: 52-116] minutes [P < .001]), and the need for additional extraction tools was higher in Group A (12.6% vs 3.4%, P < .001). Overall complication rates (5.5% vs 3.6%, P = .03) and major complication rates (3.2% vs 1.4%, P = .005), and procedural failure rates (3.5% vs 1.5%, P = .002) were significantly elevated in Group A. No significant differences were observed in procedure-related mortality (0.7% vs 0.5%, P = .592) or all-cause mortality (3.5% vs 3.2%, P = .711) between the groups. The use of additional extraction tools (odds ratio: 4.4, 95% confidence interval: 2.0-9.7, P < .001) and a body mass index ≥35 kg/m2 (odds ratio: 4.4, 95% confidence interval: 1.4-14.0, P = .012) were identified as independent predictors of procedural failure. Conclusion: Patients undergoing TLE with older leads face increased procedural complexity and complication risks, requiring more frequent use of advanced extraction techniques and experiencing lower procedural success rates. However, lead age did not impact procedure-related or overall mortality. (Copyright © 2025 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.) |
| Competing Interests: | Disclosures The following grants and personal fees were reported: Dr Chung: Medtronic. Dr Burger: Philips/Spectranetics, Cook Medical, Zoll Medical, Braun Medical, Abbott, Sorin Group/LivaNova, Impulse Dynamics, Biotronik, and Medtronic. Prof. Reichenspurner: Medtronic. Prof. Willems: Abbott, Boston Scientific, Medtronic, Boehringer Ingelheim, Bristol-Myers Squibb, Bayer Vital, Acutus, and Daiichi Sankyo. Prof. Pecha: Philips/Spectranetics, Medtronic, and AtriCure. Dr Hakmi: Boston Scientific, Edwards Lifesciences, Medtronic, Meril, Philips/Spectranetics, and Zoll Medical. All remaining authors declare no conflicts of interest regarding this paper. |
| Contributed Indexing: | Keywords: Device-related infection; Endocarditis; Lead complications; Pacemaker complication; Transvenous lead extraction |
| Entry Date(s): | Date Created: 20250807 Date Completed: 20260629 Latest Revision: 20260629 |
| Update Code: | 20260630 |
| DOI: | 10.1016/j.hrthm.2025.08.002 |
| PMID: | 40774636 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1556-3871 |
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| DOI: | 10.1016/j.hrthm.2025.08.002 |