Hofer Daniel, Bebié Michelle C, Kuster Noah, Steffel Jan, Breitenstein Alexander
Division of Electrophysiology, Department of Cardiology, University Heart Center, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
J Clin Med. 2022 Jun 22;11(13):3596. doi: 10.3390/jcm11133596.
The use of cardiac implantable electronic devices (CIEDs) to treat tachy- and bradyarrhythmia has significantly increased over the past decades. Consequently, transvenous lead extractions (TLE) have been performed more frequently, particularly in the treatment of device infection or malfunction. We aimed to evaluate the development of procedure indications and cardiovascular risk factors of patients undergoing TLE over time. and methods: 277 TLE cases from 2013 to 2020 performed at the University Hospital Zurich were included in this retrospective analysis. Patient charts and follow-up letters were screened for procedure indication and cardiovascular risk factors to evaluate trends over time. 502 leads were extracted in 273 patients. The main indications for TLE remained lead dysfunction (48.7%) and infection (31.4%) throughout the investigated period; however, infections were less and device upgrade more frequently encountered indications for TLE over time. Mean patient age at the time of TLE (64.0 ± 0.9 in the entire sample) decreased over time, while the incidence of chronic kidney disease (33.6%), heart failure (48.6%), or diabetes mellitus (22%) demonstrated an increasing trend. The main indications for TLE remain device malfunction and infection, while device upgrade was increasingly encountered as an indication for TLE in recent years. Over time, patients undergoing TLE were increasingly younger and more often presented with cardiovascular risk factors.
在过去几十年中，用于治疗快速性和缓慢性心律失常的心脏植入式电子设备（CIED）的使用显著增加。因此，经静脉导线拔除术（TLE）的实施频率更高，尤其是在治疗设备感染或故障时。我们旨在评估随时间推移接受TLE的患者的手术适应症发展情况和心血管危险因素。方法：本回顾性分析纳入了2013年至2020年在苏黎世大学医院进行的277例TLE病例。对患者病历和随访信件进行筛查，以获取手术适应症和心血管危险因素，从而评估随时间的趋势。273例患者共拔除了502根导线。在整个研究期间，TLE的主要适应症仍然是导线功能障碍（48.7%）和感染（31.4%）；然而，随着时间的推移，感染情况减少，而设备升级成为TLE更常见的适应症。TLE时的平均患者年龄（整个样本中为64.0±0.9）随时间下降，而慢性肾脏病（33.6%）、心力衰竭（48.6%）或糖尿病（22%）的发病率呈上升趋势。TLE的主要适应症仍然是设备故障和感染，而近年来设备升级越来越多地成为TLE的适应症。随着时间的推移，接受TLE的患者越来越年轻，并且更多地伴有心血管危险因素。
