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Safety and Effectiveness of Transvenous Lead Extraction in Octogenarians
Authors:GEMMA PELARGONIO  MARIA L. NARDUCCI  ELEONORA RUSSO  MICHELA CASELLA  PASQUALE SANTANGELI  ROBERT CANBY  AMIN AL‐AHMAD  LARRY D. PRICE  LUIGI DI BIASE  CANDICE J. KWARK  MARK HARWOOD  FRANCESCO PERNA  GIANLUIGI BENCARDINO  CAROLINA IERARDI  ENRICO M. TRECARICHI  ENRICA SANTELLI  MARIO TUMBARELLO  PRASANT MOHANTY  SHANE BAILEY  JOHN DAVID BURKHARDT  FULVIO BELLOCCI  ANDREA NATALE  ANTONIO DELLO RUSSO
Abstract:
Transvenous Lead Extraction . Introduction: As the population ages, the number of elderly patients with implantable cardiac devices referred for transvenous lead extraction will dramatically increase in Western countries. The safety and effectiveness of lead extraction in elderly patients has not been well evaluated. We report the safety and effectiveness of transvenous lead extraction in octogenarians. Methods and Results: From January 2005 to January 2011, we reviewed data from consecutive patients ≥ 80 years referred to our institutions for transvenous lead extraction because of cardiac device infection or lead malfunction. Clinical characteristics, procedural features, and periprocedural major and minor complications were compared between octogenarians and younger patients. Out of 849 patients undergoing lead extraction in the participating institutions during the study period, 150 (18%) patients were octogenarians (mean age 84 years; range 80–96; 64% males). A significantly higher percentage of octogenarians presented with chronic renal failure (55% vs 26%; P < 0.001), history of malignancy (22% vs 6%; P < 0.001), and chronic obstructive pulmonary disease (46% vs 19%; P < 0.001). Complete lead extraction rates were similar in the 2 age groups (97% in octogenarians vs 96% in patients <80 years; P = 0.39). Periprocedural death occurred in 2 (1.3%) patients ≥80 years and in 5 (0.72%) patients <80 years (P = 0.45 for comparison). No differences in terms of other periprocedural major and minor complications were found between the 2 age groups. Conclusion: Despite presenting with a significantly higher rate of comorbidities, transvenous lead extraction can be performed safely and successfully in octogenarians. (J Cardiovasc Electrophysiol, Vol. 23 pp. 1103‐1108, October 2012)
Keywords:elderly  implantable cardioverter defibrillator  infection  lead extraction  octogenarians  pacemaker
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