Safety and Efficacy of Transvenous Laser Lead Extraction in Octogenarians

Objectives: In an aging CIED population, more and more octogenarians are presenting for lead extraction. Octogenarians are often considered as a high-risk group for surgical procedures. We therefore investigated safety and efficacy of transvenous lead extraction in octogenarians.

Methods: Between 2013 and 2019, a total of 320 patients underwent laser lead extraction in our center. Fifty octogenarians were treated with laser lead extraction and were included in this analysis. Laser lead extraction was the primary extraction method, with additional use of mechanical rotational sheaths or femoral snares, if necessary. All procedural and patient-based data were collected into a database and retrospectively analyzed.

Result: Mean patient's age was 84.4 ± 3.3 years, 68.3% were male. A total of 126 leads had to be extracted. The mean lead dwell time of treated leads was 9.6 ± 4.3 years. Complete procedural success rate was 92.3%, while clinical success was achieved in 96.2%. Failure of extraction occurred in 3.8%. Additional mechanical rotational sheaths or femoral snares were used in 4 (7.7%) patients. Overall complication rate was 5.7%, including 2 (3.8%) major (1 RA perforation, 1 SVC perforation) and 1 (1.9%) minor complications. The patient with SVC perforation died 16 days after the procedure, corresponding to a procedure-related mortality of 1.9%.

Conclusion: Transvenous laser lead extraction in octogenarians is safe and effective when performed in experienced centers. Therefore, patients' age should not be considered as a contraindication for laser lead extraction.

Publication History

Article published online:
19 February 2021