PMID- 37937353
OWN - NLM
STAT- MEDLINE
DCOM- 20231216
LR  - 20231216
IS  - 1897-4279 (Electronic)
IS  - 0022-9032 (Linking)
VI  - 81
IP  - 11
DP  - 2023
TI  - Discontinuation of cardiac implantable electronic device therapy after 
      transvenous lead extraction.
PG  - 1113-1121
LID - 10.33963/v.kp.97655 [doi]
AB  - BACKGROUND: Patients with cardiac implantable electronic devices (CIEDs) may no 
      longer be eligible for continued therapy. AIMS: The study aimed to assess the 
      circumstances under which CIED reimplantation may not be necessary after 
      transvenous lead extraction (TLE). METHODS: A retrospective analysis of 3646 TLE 
      procedures was performed with assessment of indications for device 
      reimplantation. RESULTS: Reimplantation was not performed immediately after TLE 
      in 169 (4.6%) and, in long-term follow-up, in 146 (4.0%) of patients. No further 
      need for CIED reimplantation was mostly associated with establishment of stable 
      sinus rhythm (2.4%), conversion of sinus node dysfunction to chronic atrial 
      fibrillation (AF; 1.4%), or improvement in left ventricular ejection fraction 
      (LVEF) (0.9%). Independent prognostic factors were in the pacing groups: LVEF 
      (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01-1.05; P <0.001), AF 
      (OR, 3.8; 95% CI, 2.4-15.7; P <0.001), patients' age during first CIED 
      implantation (OR, 0.97; 95% C, 0.96-0.98; P <0.001), and New York Heart 
      Association (NYHA) class (OR, 0.616; 95% CI, 0.43-0.86; P <0.01); in the 
      cardioverter-defibrillator group: LVEF (OR, 1.06; 95% CI, 1.04-1.09; P <001). 
      Non-reimplanted patients had more complex procedures and more frequent 
      complications, but survival after TLE was better in this group of patients. 
      CONCLUSIONS: Reassessment of the need for continuation of CIED therapy should be 
      considered in all patients following lead extraction and also before planned 
      device replacement as TLE delay increases implant duration, complexity, and 
      procedural risk. The predictors of non-reimplantation are a younger age during 
      the first CIED implantation, lower NYHA class, presence of AF, and higher LVEF in 
      pacemaker carriers, and, in the defibrillator group, only higher LVEF. A decision 
      not to reimplant does not negatively affect the long-term prognosis.
FAU - Kutarski, Andrzej
AU  - Kutarski A
AD  - Department of Cardiology, Medical University, Lublin, Poland. 
      annapolewczyk@wp.pl.
FAU - Jachec, Wojciech
AU  - Jachec W
AD  - 2nd Department of Cardiology, Zabrze, Faculty of Medical Science in Zabrze, 
      Medical University of Silesia in Katowice, Katowice, Poland.
FAU - Kosior, Jaroslaw
AU  - Kosior J
AD  - Department of Cardiology, Masovian Specialistic Hospital of Radom, Radom, Poland.
FAU - Stec, Sebastian
AU  - Stec S
AD  - Division of Electrophysiology, Cardioneuroablation, Catheter Ablation and Cardiac 
      Pacing, Subcarpathian Centre for Cardiovascular Interventions, Sanok, Poland.
FAU - Nowosielecka, Dorota
AU  - Nowosielecka D
AD  - Department of Cardiology, the Pope John Paul II Province Hospital of Zamosc, 
      Zamosc, Poland.
FAU - Polewczyk, Anna
AU  - Polewczyk A
AD  - Department of Physiology, Pathophysiology and Clinical Immunology, Collegium 
      Medicum of Jan Kochanowski University, Kielce, Poland.
AD  - Department of Cardiac Surgery, Swietokrzyskie Cardiology Center, Kielce, Poland.
LA  - eng
PT  - Journal Article
DEP - 20231108
PL  - Poland
TA  - Kardiol Pol
JT  - Kardiologia polska
JID - 0376352
SB  - IM
MH  - Humans
MH  - *Defibrillators, Implantable/adverse effects
MH  - Retrospective Studies
MH  - Stroke Volume
MH  - Treatment Outcome
MH  - Ventricular Function, Left
MH  - Device Removal
MH  - *Pacemaker, Artificial/adverse effects
MH  - *Atrial Fibrillation/etiology
OTO - NOTNLM
OT  - implantable electronic device
OT  - long-term prognosis
OT  - loss of indications for pacing
OT  - superfluous CIED
OT  - unnecessary cardiac transvenous lead extraction
EDAT- 2023/11/08 06:41
MHDA- 2023/12/17 09:42
CRDT- 2023/11/08 04:13
PHST- 2023/09/29 00:00 [received]
PHST- 2023/09/29 00:00 [accepted]
PHST- 2023/12/17 09:42 [medline]
PHST- 2023/11/08 06:41 [pubmed]
PHST- 2023/11/08 04:13 [entrez]
AID - VM/OJS/J/97655 [pii]
AID - 10.33963/v.kp.97655 [doi]
PST - ppublish
SO  - Kardiol Pol. 2023;81(11):1113-1121. doi: 10.33963/v.kp.97655. Epub 2023 Nov 8.