Long‑term outcomes of non‑systematic device reimplantation following lead extraction in selected patients

Zheng,Wencheng; Ze,Feng; Yang,Dandan; Li,Ding; Zhou,Xu; Yuan,Cuizhen; Li,Xuebin

doi:10.3892/mi.2021.11

Long‑term outcomes of non‑systematic device reimplantation following lead extraction in selected patients

Authors:
- Wencheng Zheng
- Feng Ze
- Dandan Yang
- Ding Li
- Xu Zhou
- Cuizhen Yuan
- Xuebin Li
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Affiliations: Department of Cardiac Electrophysiology, Peking University People's Hospital, Peking University, Beijing 100044, P.R. China
Published online on: August 4, 2021 https://doi.org/10.3892/mi.2021.11
Article Number: 11
Copyright: © Zheng et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Following the removal of cardiovascular implantable electronic devices (CIEDs), reassessment of the need for a new device is vital. Some patients may have exhibited an improvement in rhythm or cardiac function and may thus no longer meet the guideline requirements for reimplantation. However, the long‑term outcomes of non‑systematic device reimplantation remain unknown. In the present study, it was hypothesized that the implantation of pacing systems in selected patients following lead extraction is safe. In order to confirm this hypothesis, a total of 854 patients (aged between 28 and 82 years) who underwent the removal of a CIED were enrolled in the present study and they were all reassessed to determine whether a new device following lead extraction was necessary. In order to determine which patients would undergo non‑systematic device reimplantation, the standard guidelines, the criteria and the wishes of the patient were all taken into consideration. Patients remained device‑free unless an adverse clinical event occurred that required reimplantation. The primary study endpoint was the rate of sudden death or reimplantation. Between January, 2014 and December, 2019, 854 consecutive patients underwent pacing system extraction, of whom 210 patients (24.6%) underwent non‑systematic device reimplantation following careful reassessment (the non‑reimplantation group). Among the 210 patients, 162 (77.1%) were fitted with pacemakers, 26 (12.4%) underwent cardiac resynchronization therapy or cardiac resynchronization therapy‑defibrillator and 22 (10.5%) were implanted with a cardioverter‑deﬁbrillator. During a mean follow‑up period of 40.4 months, 86 patients reached the primary endpoint of the study, including 54 out of 210 patients (25.7%) who experienced an adverse clinical event that required reimplantation and 32 out of 210 patients (15.2%) who experienced sudden death. Reimplantation of a new device was not required in ~25% of the patients. On the whole, the present study demonstrates that following pacing system removal, non‑systematic device reimplantation associated with close surveillance is safe for selected patients.

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1	Matchett M, Sears SF, Hazelton G, Kirian K, Wilson E and Nekkanti R: The implantable cardioverter defibrillator: Its history, current psychological impact and future. Expert Rev Med Devices. 6:43–50. 2009.PubMed/NCBI View Article : Google Scholar
2	Wilkoff BL, Love CJ, Byrd CL, Bongiorni MG, Carrillo RG, Crossley GH III, Epstein LM, Friedman RA, Kennergren CE, Mitkowski P, et al: Transvenous lead extraction: Heart rhythm Society expert consensus on facilities, training, indications, and patient management: This document was endorsed by the American heart association (AHA). Heart Rhythm. 6:1085–1104. 2009.PubMed/NCBI View Article : Google Scholar
3	Sohal M, Williams SE, Arujuna A, Chen Z, Bostock J, Gill JS and Rinaldi CA: The current practice and perception of cardiac implantable electronic device transvenous lead extraction in the UK. Europace. 15:865–870. 2013.PubMed/NCBI View Article : Google Scholar
4	Voigt A, Shalaby A and Saba S: Continued rise in rates of cardiovascular implantable electronic device infections in the United States: Temporal trends and causative insights. Pacing Clin Electrophysiol. 33:414–419. 2010.PubMed/NCBI View Article : Google Scholar
5	Carrasco F, Anguita M, Ruiz M, Castillo JC, Delgado M, Mesa D, Romo E, Pan M and de Lezo JS: Clinical features and changes in epidemiology of infective endocarditis on pacemaker devices over a 27-year period (1987-2013). Europace. 18:836–841. 2016.PubMed/NCBI View Article : Google Scholar
6	Aljabri K, Garlitski A, Weinstock J and Madias C: Management of device infections. Card Electrophysiol Clin. 10:153–162. 2018.PubMed/NCBI View Article : Google Scholar
7	Bashir J and Carrillo RG: Cardiac and vascular injuries sustained during transvenous lead extraction. Card Electrophysiol Clin. 10:651–657. 2018.PubMed/NCBI View Article : Google Scholar
8	Maytin M and Epstein LM: The challenges of transvenous lead extraction. Heart. 97:425–434. 2011.PubMed/NCBI View Article : Google Scholar
9	Hauser RG, Katsiyiannis WT, Gornick CC, Almquist AK and Kallinen LM: Deaths and cardiovascular injuries due to device-assisted implantable cardioverter-defibrillator and pacemaker lead extraction. Europace. 12:395–401. 2010.PubMed/NCBI View Article : Google Scholar
10	Nof E, Bongiorni MG, Auricchio A, Butter C, Dagres N, Deharo JC, Rinaldi CA, Maggioni AP, Kutarski A, Kennergren C, et al: Comparison of outcomes in infected cardiovascular implantable electronic devices between complete, partial, and failed lead removal: An ESC-EHRA-EORP ELECTRa (European Lead Extraction ConTrolled) registry. Europace. 21:1876–1889. 2019.PubMed/NCBI View Article : Google Scholar
11	Kusumoto FM, Schoenfeld MH, Wilkoff BL, Berul CI, Birgersdotter-Green UM, Carrillo R, Cha YM, Clancy J, Deharo JC, Ellenbogen KA, et al: 2017 HRS expert consensus statement on cardiovascular implantable electronic device lead management and extraction. Heart Rhythm. 14:e503–e551. 2017.PubMed/NCBI View Article : Google Scholar
12	Chew D, Somayaji R, Conly J, Exner D and Rennert-May E: Timing of device reimplantation and reinfection rates following cardiac implantable electronic device infection: A systematic review and meta-analysis. BMJ Open. 9(e029537)2019.PubMed/NCBI View Article : Google Scholar
13	Brignole M, Auricchio A, Baron-Esquivias G, Bordachar P, Boriani G, Breithardt OA, Cleland J, Deharo JC, Delgado V, Elliott PM, et al: 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: The task force on cardiac pacing and resynchronization therapy of the European society of cardiology (ESC). Developed in collaboration with the European heart rhythm association (EHRA). Eur Heart J. 34:2281–2329. 2013.PubMed/NCBI View Article : Google Scholar
14	Priori SG, Blomström-Lundqvist C, Mazzanti A, Blom N, Borggrefe M, Camm J, Elliott PM, Fitzsimons D, Hatala R, Hindricks G, et al: 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The task force for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European society of cardiology (ESC)endorsed by: Association for European paediatric and congenital cardiology (AEPC). Europace. 17:1601–1687. 2015.PubMed/NCBI View Article : Google Scholar
15	Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, et al: 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: The task force for the diagnosis and treatment of acute and chronic heart failure of the European society of cardiology (ESC)developed with the special contribution of the heart failure association (HFA) of the ESC. Eur Heart J. 37:2129–2200. 2016.PubMed/NCBI View Article : Google Scholar
16	Shen WK, Sheldon RS, Benditt DG, Cohen MI, Forman DE, Goldberger ZD, Grubb BP, Hamdan MH, Krahn AD, Link MS, et al: 2017 ACC/AHA/HRS guideline for the evaluation and management of patients with syncope: A report of the American college of cardiology/American heart association task force on clinical practice guidelines and the heart rhythm society. J Am Coll Cardiol. 70:e39–e110. 2017.PubMed/NCBI View Article : Google Scholar
17	Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR, Goldschlager NF, Hamilton RM, Joglar JA, Kim RJ, et al: 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: A report of the american college of cardiology/American heart association task force on clinical practice guidelines and the heart rhythm society. Circulation. 140:e382–e482. 2019.PubMed/NCBI View Article : Google Scholar
18	Rickard J, Tarakji K, Cronin E, Brunner MP, Jackson G, Baranowski B, Borek PP, Martin DO, Wazni O and Wilkoff BL: Cardiac venous left ventricular lead removal and reimplantation following device infection: A large singal-center experience. J Cardiovasc Electrophysiol. 23:1213–1216. 2012.PubMed/NCBI View Article : Google Scholar
19	Cacoub P, Leprince P, Nataf P, Hausfater P, Dorent R, Wechsler B, Bors V, Pavie A, Piette JC and Gandjbakhch I: Pacemaker infective endocarditis. Am J Cardiol. 82:480–484. 1998.PubMed/NCBI View Article : Google Scholar
20	Lewis AB, Hayes DL, Holmes DR Jr, Vlietstra RE, Pluth JR and Osborn MJ: Update on infections involving permanent pacemakers: Characterization and management. J Thorac Cardiovasc Surg. 89:758–763. 1985.PubMed/NCBI
21	Böhm Á, Bányai F, Préda I and Zámolyi K: The treatment of septicemia in pacemaker patients. Pacing Clin Electrophysiol. 19:1105–1111. 1996.PubMed/NCBI View Article : Google Scholar
22	Chua JD, Wilkoff BL, Lee I, Juratli N, Longworth DL and Gordon SM: Diagnosis and management of infections involving implantable electrophysiologic cardiac devices. Ann Intern Med. 133:604–608. 2000.PubMed/NCBI View Article : Google Scholar
23	Calkins H, Hindricks G, Cappato R, Kim YH, Saad EB, Aguinaga L, Akar JG, Badhwar V, Brugada J, Camm J, et al: 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation. Europace. 20:e1–e160. 2018.PubMed/NCBI View Article : Google Scholar
24	Erkapic D, Sperzel J, Stiller S, Meltendorf U, Mermi J, Wegscheider K and Hügl B: INSURE Investigators. Long-term benefit of implantable cardioverter/defibrillator therapy after elective device replacement: Results of the incidence free survival after ICD replacement (INSURE) trial-a prospective multicentre study. Eur Heart J. 34:130–137. 2013.PubMed/NCBI View Article : Google Scholar
25	Van Welsenes GH, Rees JB, Thijssen J, Trines SA, Erven LV, Schalij MJ and Borleffs CJW: Primary prevention implantable cardioverter defibrillator recipients: The need for defibrillator back-up after an event-free first battery service-life. J Cardiovasc Electrophysiol. 22:1346–1350. 2011.PubMed/NCBI View Article : Google Scholar
26	Marijon E, Guillebon MD, Bordachar P, Jacob S, Vahdat O, Sidobre L, Deplagne A, Combes N, Albenque JP, Clementy J, et al: Safety of deferring the reimplantation of pacing systems after their removal for innfectious complications in selected patients: A 1-year follow-up study. J Cardiovasc Electrophysiol. 21:540–544. 2010.PubMed/NCBI View Article : Google Scholar