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Heart and Vessels

, Volume 33, Issue 10, pp 1245–1250 | Cite as

Differences in laser lead extraction of infected vs. non-infected leads

  • Simon Pecha
  • Liesa Castro
  • Julia Vogler
  • Matthias Linder
  • Nils Gosau
  • Stephan Willems
  • Hermann Reichenspurner
  • Samer Hakmi
Original Article
  • 116 Downloads

Abstract

We investigated the effect of systemic infection or lead endocarditis on the complexity and the success of laser lead extraction (LLE) procedures. Medical records of all patients undergoing LLE between January 2012 and March 2017 were screened with regard to information on systemic infection or lead endocarditis. We treated 184 patients using high-frequency 80 Hz laser sheaths in patients with lead implant duration of ≥ 12 months. Indications for lead extraction were systemic infection and lead endocarditis in 52 cases (28.3%), local infection in 74 cases (40.2%), lead dysfunction in 37 cases (20.1%) and other indications in 21 cases (11.4%). 386 leads were scheduled for LLE: 235 (60.9%) pacing, 105 (27.2%) ICD and 46 (11.9%) CS leads. The mean time from initial lead implantation (systemic infection 96.8 ± 74.7 months vs. 102.1 ± 82.6 non-infected: months; p = 0.4155) and ratio of ICD leads (26.8 vs. 27.4%; p = 0.3411) did not differ significantly between the two groups. Complete procedural success was significantly higher in the systemic infection group (100 vs. 94.7%; p = 0.0077). The mean laser treatment (60.2 ± 48.7 vs. 72.4 ± 61.5 s; p = 0.2038) was numerically lower in the infection group, while fluoroscopy time (9.3 ± 7.6 vs. 12.8 ± 10.3 min; p = 0.0275) was significantly lower in this group. Minor and major complications were low in both groups and did not reveal any statistically significant difference (infected group: one minor complication; pocket hematoma, non-infected: three major complications; emergent sternotomy due to pericardial tamponade). No extraction related mortality was observed. The presence of systemic infection or lead endocarditis in LLE procedures allows for higher complete procedural success. When compared with LLE of non-infected leads, the infected leads require less laser and fluoroscopy times. Due to the scarcity of minor and major complications in general, no statistical significance was found in that regard.

Keywords

Laser lead extraction Lead endocarditis CIED infections Pacemaker infection 

Notes

Funding

No funding was received for this study.

Compliance with ethical standards

Conflict of interest

Samer Hakmi is a Proctor of Spectranetics Corp.

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Copyright information

© Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Cardiovascular SurgeryUniversity Heart Center HamburgHamburgGermany
  2. 2.Department of Cardiology, ElectrophysiologyUniversity Heart Center HamburgHamburgGermany

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