Hofer Daniel, Kuster Noah, Bebié Michelle C, Sasse Tom, Steffel Jan, Breitenstein Alexander
Division of Electrophysiology, Department of Cardiology, University Heart Center, University Hospital Zurich, 8091 Zurich, Switzerland.
J Clin Med. 2023 Mar 14;12(6):2260. doi: 10.3390/jcm12062260.
Transvenous lead extractions are increasingly performed for malfunction or infection of cardiac implantable electronic devices, but they harvest a potential for complications and suboptimal success. Apart from multicenter registries and reports from highly experienced single centers, the outcome in individual newly developing high-volume centers starting a lead extraction program is less well established. We aimed to evaluate the clinical and radiological success and complication rate at our center, having started a lead extraction program less than a decade ago.
We retrospectively analyzed patients who underwent transvenous lead extraction at the University Hospital Zurich from 2013 to 2021 regarding success as well as complications and compared our results to previously reported outcome rates.
A total of 346 patients underwent 350 transvenous lead extractions from January 2013 to December 2021. Combined radiological success was achieved in 97.7% and clinical success in 96.0% of interventions. Procedure-related major complications occurred in 13 patients (3.7%). Death within 30 days after transvenous lead extractions occurred in 13 patients (3.7%), with a procedure-related mortality of 1.4% (five patients).
Transvenous lead extractions in newly developing high-volume centers can be performed with high clinical and radiological success rates, but procedure-related major complications may affect a relevant number of patients. Compared to large single or multicenter registries of experienced centers, the success rate may be lower and the complication rate higher in centers newly starting with lead extraction, which may have important implications for patient selection, procedural planning, proctoring, and safety measures.
经静脉导线拔除术越来越多地用于治疗心脏植入式电子设备的故障或感染，但该手术存在并发症风险且成功率不尽人意。除了多中心注册研究和经验丰富的单中心报告外，新成立的高容量中心开展导线拔除项目的个体结果尚不太明确。我们旨在评估我们中心（在不到十年前开始开展导线拔除项目）的临床和影像学成功率以及并发症发生率。
我们回顾性分析了2013年至2021年在苏黎世大学医院接受经静脉导线拔除术的患者的手术成功率及并发症情况，并将我们的结果与先前报道的结果率进行比较。
2013年1月至2021年12月，共有346例患者接受了350次经静脉导线拔除术。97.7%的干预措施取得了联合影像学成功，96.0%取得了临床成功。13例患者（3.7%）发生了与手术相关的严重并发症。经静脉导线拔除术后30天内死亡的患者有13例（3.7%），与手术相关的死亡率为1.4%（5例患者）。
新成立的高容量中心进行经静脉导线拔除术可获得较高的临床和影像学成功率，但与手术相关的严重并发症可能会影响相当数量的患者。与经验丰富的大型单中心或多中心注册研究相比，刚开始开展导线拔除术的中心成功率可能较低，并发症发生率可能较高，这可能对患者选择、手术规划、指导及安全措施具有重要意义。
