Indications for transvenous lead extraction and its procedural and early outcomes in elderly patients: a single-center experience

Pol Arch Intern Med. 2020 Mar 27;130(3):216-224. doi: 10.20452/pamw.15182. Epub 2020 Feb 10.


Introduction: Due to the prolonged survival of patients with cardiovascular implantable electronic devices, leads often need to be removed in elderly individuals.

Objectives: We aimed to analyze indications for transvenous lead extraction (TLE), procedure effectiveness and safety, as well as 30‑day follow‑up in younger patients (≤80 years) and octogenarians (>80 years).

Patients and methods: This prospective study included 667 patients who underwent TLE: 90 octogenarians (13.5%) at a mean age of 83.8 (range, 80.4-93) years and 577 younger patients (86.5%) at a mean age of 64.2 (range, 18.9-79.9) years.

Results: Octogenarians had a greater number of comorbidities, fewer implantable cardioverter‑defibrillators implanted, and more frequently had infection as an indication for TLE, as compared with younger patients (33.3% vs 17.1%; P <0.001). In octogenarians, 138 leads were extracted, as compared with 894 leads in younger patients. Octogenarians and younger patients had similar rates of complete lead removal (98.6% and 97.1%, respectively; P = 0.48), total procedural success (97.8% and 96%, respectively; P = 0.7), major complications (0% and 1.6%, respectively; P = 0.45), and minor complications (2.2% and 1.6%, respectively; P = 0.45). There was 1 death associated with TLE in younger patients. Non-procedure‑related deaths within 30 days after TLE were more frequent in octogenarians than in younger patients (5.6% vs 1.9%; P = 0.04).

Conclusion: We showed that TLE in patients older than 80 years seems to be as effective as in younger patients; however, it is associated with significantly higher non-procedure‑related 30‑day mortality.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Defibrillators, Implantable*
  • Device Removal*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Safety
  • Poland
  • Prospective Studies
  • Risk Factors
  • Treatment Outcome