Transvenous lead extraction: procedural outcomes and in-hospital mortality in octogenarian patients

Abstract Background Managing elderly patients with infection or malfunction deriving from a cardiac implantable electronic device (CIED) may be challenging. The aim of this study was to evaluate safety and efficacy of mechanical transvenous lead extraction (TLE) in elderly patients. Methods Patients who had undergone TLE in single tertiary referral center were divided in two groups (Group 1: ≥80 years; group 2:<80 years) and their acute and chronic outcomes were compared. All patients were treated with manual traction or mechanical dilatation. Results Our analysis included 1316 patients (group 1: 202, group 2: 1114 patients), with a total of 2513 leads extracted. Group 1 presented more comorbidities and more pacemakers, whereas the dwelling time of the oldest lead was similar, irrespectively of patient's age. In group 1 the radiological success rate for lead was higher (99.0% vs 95.9%; P<0.001) and the fluoroscopy time lower (13.0 vs 15.0 minutes; P=0.04) than in group 2. Clinical success was reached in 1273 patients (96.7%), without significant differences between groups (group 1: 98.0% vs group 2: 96.4%; P=0.36). Major complications occurred in 10 patients (0.7%) without significative differences between patients with more or less than 80 years (group 1: 1.5% vs group 2: 0.6%; P=0.24). In the elderly group no in-hospital mortality occurred (0.0% vs 0.5%; P=0.42). Conclusions Mechanical TLE in elderly patients is a safe and effective procedure. In the over-80s, a comparable incidence of major complications with younger patients was observed, with at least a similar efficacy of the procedure and no procedural-related deaths. Funding Acknowledgement Type of funding source: None

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1260Transvenous lead extraction: efficacy and safety of the procedure in octogenarian patients

EP Europace ◽

10.1093/europace/euaa162.015 ◽

2020 ◽

Vol 22 (Supplement_1) ◽

Author(s):

M Giannotti Santoro ◽

L Segreti ◽

G Zucchelli ◽

V Barletta ◽

F Fiorentini ◽

...

Keyword(s):

Elderly Patients ◽

Electronic Device ◽

Clinical Success ◽

Lead Extraction ◽

Efficacy And Safety ◽

Cardiac Implantable Electronic Device ◽

Major Complications ◽

Group 2 ◽

Manual Traction ◽

Group 1

Abstract Introduction the management of patients with infection or malfunction of a cardiac implantable electronic device (CIED) may be challenging. Purpose The aim of the study is to evaluate the safety and efficacy of transvenous lead extraction (TLE) in elderly patients. Methods a retrospective analysis of patients who underwent to TLE in our center was performed. Patients were divided in two groups: 1) patients 80 years of age or older, 2) patients younger than 80 years. All patients were treated with manual traction or mechanical dilatation. Results our analysis included 1316 patients, with a total of 2513 leads extracted. Group 1 (≥80 years) counted 202 patients and group 2 (<80 years) 1114 patients. The group of elderly patients presented more comorbidities, as hypertension, chronic kidney disease, atrial fibrillation and pulmonary disease. Patients 80 years of age or older had more pacemakers than ICDs, whereas the dwelling time of the oldest lead, the number of leads and the presence of abandoned leads was similar despite patients age. In group 1 the rate of radiological success for lead was higher than in group 2 (99.0% vs 95.9%; P < 0.001). The clinical success was obtained in 1273 patients (96.7%), without significative differences between groups (98.0% vs 96.4%; P = 0.36). Major complications occurred in 10 patients (0.7%), without significative differences (1.5% vs 0.6%; P = 0.24) (figure 1). Conclusion TLE in elderly patients is a safe and effective procedure. In patients older than 80 years there are not more major complications than in younger patients, and the efficacy of the procedure seems to be superior. Abstract Figure 1

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Safety and efficacy of transvenous mechanical lead extraction in patients with abandoned leads

EP Europace ◽

10.1093/europace/euaa134 ◽

2020 ◽

Vol 22 (9) ◽

pp. 1401-1408

Author(s):

Luca Segreti ◽

Mario Giannotti Santoro ◽

Andrea Di Cori ◽

Federico Fiorentini ◽

Giulio Zucchelli ◽

...

Keyword(s):

Clinical Success ◽

Lead Extraction ◽

Safe Procedure ◽

Optimal Management ◽

Clinical Failure ◽

Implantation Time ◽

Safety And Efficacy ◽

Dwelling Time ◽

Group 2 ◽

Group 1

Abstract Aims Optimal management of redundant or malfunctioning leads is controversial. We aimed to assess safety and efficacy of mechanical transvenous lead extraction (TLE) in patients with abandoned leads. Methods and results Consecutive TLE procedures performed in our centre from January 2009 to December 2017 were considered. We evaluated the safety and efficacy of mechanical TLE in patients with abandoned (Group 1) compared to non-abandoned (Group 2) leads. We analysed 1210 consecutive patients that required transvenous removal of 2343 leads. Group 1 accounted for 250 patients (21%) with a total of 617 abandoned leads (26%). Group 2 comprised 960 patients (79%) with 1726 leads (74%). The total number of leads (3.0 vs. 2.0), dwelling time of the oldest lead (108.00 months vs. 60.00 months) and infectious indications for TLE were higher in Group 1. Clinical success was achieved in 1168 patients (96.5%) with a lower rate in Group 1 (90.4% vs. 98.1%; P < 0.001). Major complications occurred in only 9 patients (0.7%), without significant differences among the two groups. The presence of one or more abandoned leads [odds ratio (OR) 3.47; 95% confidence interval (CI) 1.07–11.19; P = 0.037] and dwelling time of the oldest lead (OR 1.01 for a month; 95% CI 1.01–1.02; P < 0.001) were associated with a higher risk of clinical failure. Conclusion Transvenous mechanical lead extraction is a safe procedure also in high-risk settings, as patients with abandoned leads. Success rate resulted a bit lower, especially in the presence of abandoned leads with long implantation time.

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Micra pacemaker implant after cardiac implantable electronic device extraction: feasibility and long-term outcomes

EP Europace ◽

10.1093/europace/euz160 ◽

2019 ◽

Vol 21 (8) ◽

pp. 1229-1236 ◽

Cited By ~ 4

Author(s):

Giulio Zucchelli ◽

Valentina Barletta ◽

Veronica Della Tommasina ◽

Stefano Viani ◽

Matteo Parollo ◽

...

Keyword(s):

Electronic Device ◽

Superior Vena ◽

Vena Cava ◽

Electrical Performance ◽

Lead Extraction ◽

Safe Procedure ◽

Group 2 ◽

Group 1

Abstract Aims We aimed at investigating the feasibility and outcome of Micra implant in patients who have previously undergone transvenous lead extraction (TLE), in comparison to naïve patients implanted with the same device. Methods and results Eighty-three patients (65 males, 78.31%; 77.27 ± 9.96 years) underwent Micra implant at our centre. The entire cohort was divided between ‘post-extraction’ (Group 1) and naïve patients (Group 2). In 23 of 83 patients (20 males, 86.96%; 73.83 ± 10.29 years), Micra was implanted after TLE. Indication to TLE was an infection in 15 patients (65.21%), leads malfunction in four (17.39%), superior vena cava syndrome in three (13.05%), and severe tricuspid regurgitation in one case (4.35%). The implant procedure was successful in all patients and no device-related events occurred at follow-up (median: 18 months; interquartile range: 1–24). No differences were observed between groups in fluoroscopy time (13.88 ± 10.98 min vs. 13.15 ± 6.64 min, P = 0.45), single device delivery (Group 1 vs. Group 2: 69.56% vs. 55%, P = 0.22), electrical performance at implant and at 12-month follow-up (Group 1 vs. Group 2: pacing threshold 0.48 ± 0.05 V/0.24 ms vs. 0.56 ± 0.25 V/0.24 ms, P = 0.70; impedance 640 ± 148.83 Ohm vs. 583.43 ± 99.7 Ohm, P = 0.27; and R wave amplitude 10.33 ± 2.88 mV vs. 12.62 ± 5.31 mV, P = 0.40). A non-apical site of implant was achievable in the majority of cases (72.3%) without differences among groups (78.26% vs. 70%; P = 0.42). Conclusion Micra implant is an effective and safe procedure in patients still requiring a ventricular pacing after TLE, with similar electrical performance and outcome compared with naïve patients at long-term follow-up.

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Geriatric Proximal Femur Fractures During the Covid-19 Pandemic - Fewer Cases, But More Comorbidities

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/21514593211009657 ◽

2021 ◽

Vol 12 ◽

pp. 215145932110096

Author(s):

Christina Polan ◽

Heinz-Lothar Meyer ◽

Manuel Burggraf ◽

Monika Herten ◽

Paula Beck ◽

...

Keyword(s):

Nursing Home ◽

Elderly Patients ◽

Proximal Femur ◽

Minor Trauma ◽

Proximal Femur Fractures ◽

Femur Fractures ◽

Number Of Patients ◽

Group 2 ◽

The Impact ◽

Group 1

Background: The COVID-19 pandemic is challenging healthcare systems worldwide. This study examines geriatric patients with proximal femur fractures during the COVID-19 pandemic, shifts in secondary disease profile, the impact of the pandemic on hospitalization and further treatment. Methods: In a retrospective monocentric study, geriatric proximal femur fractures treated in the first six months of 2020 were analyzed and compared with the same period of 2019. Pre-traumatic status (living in a care home, under supervision of a legal guardian), type of trauma, accident mechanism, geriatric risk factors, associated comorbidities, time between hospitalization and surgery, inpatient time and post-operative further treatment of 2 groups of patients, aged 65-80 years (Group 1) and 80+ years (Group 2) were investigated. Results: The total number of patients decreased (70 in 2019 vs. 58 in 2020), mostly in Group 1 (25 vs. 16) while the numbers in Group 2 remained almost constant (45 vs. 42). The percentage of patients with pre-existing neurological conditions rose in 2020. This corresponded to an increase in patients under legal supervision (29.3%) and receiving pre-traumatic care in a nursing home (14.7%). Fractures were mostly caused by minor trauma in a home environment. In 2020, total number of inpatient days for Group 2 was lower compared to Group 1 (p = 0.008). Further care differed between the years: fewer Group 1 patients were discharged to geriatric therapy (69.6% vs. 25.0%), whereas in Group 2 the number of patients discharged to a nursing home increased. Conclusions: Falling by elderly patients is correlated to geriatric comorbidities, consequently there was no change in the case numbers in this age group. Strategic measures to avoid COVID-19 infection in hospital setting could include reducing the length of hospital stays by transferring elderly patients to a nursing home as soon as possible and discharging independent, mobile patients to return home.

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Abstract 15948: Impact of Age on Safety of Radiofrequency Ablation in Patients With Atrial Fibrillation

Circulation ◽

10.1161/circ.130.suppl_2.15948 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Janet W Elcano ◽

Hui Nam Pak

Keyword(s):

Atrial Fibrillation ◽

Phrenic Nerve Palsy ◽

Adjusted Risk ◽

Ablation Time ◽

Group 4 ◽

Major Complications ◽

Group 3 ◽

Group 2 ◽

The Impact ◽

Group 1

Background: The incidence of atrial fibrillation (AF) is increasing in the elderly population, however, there is paucity of data on the safety outcomes of this patient subgroup thus we sought to investigate on the impact of age on the safety of catheter ablation for AF. Methods and Results: We included 1,293 (male 75%) patients enrolled in Yonsei AF Ablation Cohort database in Seoul, South Korea, from March 2009 to November 2013. We divided the patients into 4 groups according to age (Group 1, aged 17-49, N=295 ; Group 2 50-59, N=421; Group 3 60-69 N=408; and Group 4 ≥ 70, N=169) and evaluated the incidence of procedure related complications. No procedure-related death occurred in this study. There was a trend of increasing incidence of procedure related complications with age noted as follows: Group 1= 3.7%; Group 2= 4.0%; Group 3=6.6%; and Group 4 7.1%, (p= 0.15). There were 28 cases (2.2%) of major complications (Group 1=1.7%, Group 2=1.9%, Group 3=2%, Group 4 4.1%), tamponade being the most common. Major complications in group 4 include: tamponade 4 cases, phrenic nerve palsy 1 case, atrioesophaeal fistula 1 and 3rd degree AV block in 1 patient. Multivariate regression analysis shows ablation time (odds ratio (OR) 1.2 confidence interval (CI)1.0-1.017, p=0.017), procedure time (OR 1.008, CI 1.0-1.15, p=0.04), decreasing eGFR (OR 1.013, CI 1.002-1.026 p=0.018), coronary artery disease (CAD) (OR 1.847, CI 1.003-3.524, p0.04) and age (OR 1.028, CI 1.003-1.055, p=0.03) were associated with increased adjusted risk of total complications. Predictors of major complications include age (OR 1.044, CI 1.003-1.086, p0.02) and ablation time (OR 1.009, CI 0.999-1.000, p=0.033). Conclusion: Our data suggest that incidence of procedural complications in RFA of AF increase with age. Ablation time and age are independent predictors of a major complication.

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Predictors of success and complications in laser lead extraction

EP Europace ◽

10.1093/europace/euab116.481 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

T Madej ◽

K Matschke ◽

M Knaut

Keyword(s):

Adverse Events ◽

Electronic Device ◽

Clinical Success ◽

Multivariable Analysis ◽

Lead Extraction ◽

Predictors Of Success ◽

Funding Sources ◽

Icd Leads ◽

Short Term Mortality ◽

Major Adverse Events

Abstract Funding Acknowledgements Type of funding sources: None. Background Extraction of cardiac implantable electronic device (CIED) leads using excimer laser is in use since > 20 years, but the predictors of success, all-cause complications and mortality are not yet sufficiently statistically evaluated. Method All consecutive laser extractions performed at our institution between September 2011 and March 2020 with lead age > 12 months were included and retrospectively analysed. Results 792 leads (mean age 75 months) were extracted during 335 procedures. The indication for extraction was pocket infection in 59%, CIED endocarditis in 25%, lead dysfunction or upgrade in 14% and others in 2%. 94.6% of leads were extracted complete, 4.2% partial (< 4 cm rest) and the extraction failed in 1.3% of the leads (retention of ≥ 4 cm rest). Multivariable analysis identified lead age > 7.5 years (odds ratio [OR] 6.5; p = 0.0281), broken leads (OR 28.0; p = 0.0009) and implantable cardioverter-defibrillator (ICD) leads (OR 6.5; p = 0.0010) as independent predictors of failed extraction. CIED-endocarditis was independently associated with complete extraction (OR 3.3; p = 0.0218). Complete procedural success or clinical success was achieved in 330 of 335 procedures (98.6%). The lead extraction failed in five cases (1.5%). Major procedure-associated adverse events (injuries of the great vessels or heart) occurred in four cases (1.2%). Two patients died perioperatively (0.6%). Minor complications occurred in 13 cases (3.9%). Major adverse events (MAE) causally not related to the procedure occurred in 18 (5.4%) of the patients. The most frequent MAE was postoperative aggravation of the sepsis (10 patients; 3.0%). Independent predictors of major adverse events were CIED-endocarditis (OR 6.0; p = 0.0175), preoperative C-reactive-protein (CRP) > 35 mg/l (OR 3.8; p = 0.0412) and body mass index (BMI) ≥ 25 kg/m2 (OR 5.0; p = 0.0489). Ten patients (3%) died during the hospital stay. CIED-endocarditis with preoperative CRP > 35 mg/l was independently associated with hospital mortality in multivariable analysis (OR 10.7; p = 0.0020). The Kaplan-Meyer analysis of 30-day mortality showed a significantly worse survival of patients with endocarditis (Log-Rank p = 0.0102). Conclusion Leads > 7.5 years, broken leads and ICD leads are independent predictors of failed extraction. CIED endocarditis, CRP > 35 and BMI ≥ 25 are associated with MAE. CIED endocarditis is related to higher short-term mortality despite successful lead extraction. Abstract Figure. Predictors of major adverse events

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Abstract WP380: Thyrotoxicosis is Associated With Worse In-Hospital Mortality in Patients With Ischemic Stroke

Stroke ◽

10.1161/str.51.suppl_1.wp380 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Sakiru O Isa ◽

Olajide Buhari ◽

Hameem Changezi

Keyword(s):

Ischemic Stroke ◽

Hospital Mortality ◽

Length Of Hospital Stay ◽

The Body ◽

Significant Difference ◽

History Of ◽

Group 3 ◽

Group 2 ◽

Time Of Presentation ◽

Group 1

Introduction: Hyperthyroidism increases the basal metabolic rate and affects most systems in the body. Patients with hyperthyroidism have been shown to have a higher incidence of ischemic stroke. There is a paucity of information regarding its effects on the short-term outcomes of patients admitted with ischemic stroke. Hypothesis: Hyperthyroidism is associated with worse in-hospital outcomes in patients admitted for ischemic stroke. Methods: We queried the National Inpatient Sample to identify adult patients(aged 18 and above) admitted for ischemic stroke between January 2011 and December 2014. We compared those with a history of hyperthyroidism (group 1) and thyrotoxicosis on admission (group 2) with the rest of the patients (group 3). The main outcome was in-hospital mortality. Secondary outcomes included the length of hospital stay and cost of hospitalization. We used the logistic regression model and adjusted for baseline characteristics and co-morbidities. Results: There were 643,786 patients in the study, 0.44% had a history of hyperthyroidism, and 0.01% had thyrotoxicosis at the time of presentation. The odd of mortality in group 1 compared to group 3 was 0.89, 95% CI 0.75-1.05, p=0.16 while in group 2 compared to group 3, it was 2.42, 95% CI 1.29-4.52, p<0.006. The mean length of stay was also longer in group 2 with a mean difference of 8.06, 95% CI 4.74 - 11.39, p<0.0001. Conclusion: From the study, there was no significant difference in in-hospital mortality between patients with previously diagnosed hyperthyroidism and those without diagnosed hyperthyroidism. Patients who had thyrotoxicosis on admission, on the other hand, had worse outcomes compared to patients without thyrotoxicosis.

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Long-term follow-up of abandoned transvenous defibrillator leads: a nationwide cohort study

EP Europace ◽

10.1093/europace/euaa086 ◽

2020 ◽

Vol 22 (7) ◽

pp. 1097-1102

Author(s):

Anders Fyhn Elgaard ◽

Jens Brock Johansen ◽

Jens Cosedis Nielsen ◽

Christian Gerdes ◽

Sam Riahi ◽

...

Keyword(s):

Clinical Success ◽

Extraction Procedure ◽

Clinical Success Rate ◽

High Volume ◽

Lead Extraction ◽

Related Data ◽

Major Complications ◽

Long Term Follow Up

Abstract Aims Commonly, a dysfunctional defibrillator lead is abandoned and a new lead is implanted. Long-term follow-up data on abandoned leads are sparse. We aimed to investigate the incidence and reasons for extraction of abandoned defibrillator leads in a nationwide cohort and to describe extraction procedure-related complications. Methods and results All abandoned transvenous defibrillator leads were identified in the Danish Pacemaker and ICD Register from 1991 to 2019. The event-free survival of abandoned defibrillator leads was studied, and medical records of patients with interventions on abandoned defibrillator leads were audited for procedure-related data. We identified 740 abandoned defibrillator leads. Meantime from implantation to abandonment was 7.2 ± 3.8 years with mean patient age at abandonment of 66.5 ± 13.7 years. During a mean follow-up after abandonment of 4.4 ± 3.1 years, 65 (8.8%) abandoned defibrillator leads were extracted. Most frequent reason for extraction was infection (pocket and systemic) in 41 (63%) patients. Procedural outcome after lead extraction was clinical success in 63 (97%) patients. Minor complications occurred in 3 (5%) patients, and major complications in 1 (2%) patient. No patient died from complication to the procedure during 30-day follow-up after extraction. Conclusion More than 90% of abandoned defibrillator leads do not need to be extracted during long-term follow-up. The most common indication for extraction is infection. Abandoned defibrillator leads can be extracted with high clinical success rate and low risk of major complications at high-volume centres.

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Intestinal Obstruction due to Bezoar in Elderly Patients: Risk Factors and Treatment Results

Emergency Medicine International ◽

10.1155/2019/3647356 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Fatih Altintoprak ◽

Eyup Gemici ◽

Yasin Alper Yildiz ◽

Mustafa Yener Uzunoglu ◽

Taner Kivilcim

Keyword(s):

Risk Factors ◽

Peptic Ulcer ◽

Surgical Technique ◽

Abdominal Surgery ◽

Elderly Patients ◽

Intestinal Obstruction ◽

History Of ◽

Group 2 ◽

Length Of Hospitalization ◽

Group 1

Purpose. Bezoars are foreign particles from the accumulation of indigestible materials in the gastrointestinal system and a rare cause of mechanical intestinal obstruction. We aimed at investigating differences in risk factors for the development of intestinal obstruction associated with bezoar in elderly patients.Methods. Hospital records of patients who underwent surgery associated with phytobezoar between January 2004 and May 2016 were retrospectively evaluated. Patients were divided into two groups [<65 years (Group 1) and ≥65 years (Group 2)]. Data were examined regarding presence of comorbidity, history of abdominal surgery, operation time, bezoar site, surgical technique, length of hospitalization, morbidity, and mortality.Results. Of 121 patients enrolled, 48 (39.7%) were male and 73 (60.3%) were female (range: 24-86 years). Group 1 consisted of 69 patients aged < 65, while Group 2 consisted of 52 patients aged ≥ 65. Comorbidity was reported in 52 (42.9%) patients (mostly diabetes mellitus, 20.7%), while 60 patients (49.6%) had history of abdominal surgery (mostly peptic ulcer, 27.3%). No statistical differences were found between the two groups in terms of sex, bezoar site, surgical technique preferred, history of abdominal surgical intervention, pre- and postoperative CT examination, morbidity rates, and length of hospitalization. But, ratio of peptic ulcer operations history, presence of total comorbidity, and time of surgery decision was higher in Group 2 patients.Conclusion. In bezoar-related intestinal obstruction, duration and outcome of treatment are not affected by age distribution. Possibility of bezoar should primarily be considered in elderly patients with history of peptic ulcer operation.

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P2857Implantable cardioverter defibrillator and pacemaker lead extraction: is it safe to do it again?

European Heart Journal ◽

10.1093/eurheartj/ehz748.1166 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A Cubberley ◽

P Sharedalal ◽

N Shah ◽

G Essilfie ◽

G Burkman ◽

...

Keyword(s):

Coronary Artery ◽

Electronic Device ◽

Artery Bypass ◽

Bypass Graft ◽

Systolic Heart Failure ◽

Adverse Outcomes ◽

Lead Extraction ◽

Major Complications ◽

Significant Difference ◽

First Time

Abstract Background/Introduction There are growing numbers of transvenous implantable devices for patients requiring permanent pacemakers (PPM) as well as Implantable Cardioverter Defibrillators (ICD). As such, there has been a concomitant increased need for lead extraction. Lead extraction is associated with increased morbidity and mortality (Hamid, 2010). Comparative outcomes of repeat lead extraction are not extensively studied. Purpose We compared demographics as well as major and minor adverse outcomes in patients undergoing first time vs. repeat lead extraction procedures. Methods In our single center study, 1278 extractions took place between January 2004 and December of 2018. Of these 1177 patients underwent PPM or ICD lead extraction for the first time; 101 patients underwent repeat extractions. Baseline characteristics including gender, history of coronary artery bypass graft (CABG) surgery, hypertension (HTN), systolic heart failure (HF) defined as ejection fraction <40%, hyperlipidemia (HLD), diabetes mellitus (DM), and coronary artery disease (CAD) were evaluated using chi-squared analysis. Adverse events, as defined by the 2017 HRS Expert Consensus Statement on Cardiovascular Implantable Electronic Device Lead Management and Extraction, were identified as major complications (death, cardiac arrest, cardiac perforation, coronary venous dissection, pericardial tamponade, or urgent cardiac surgery), and minor complications (coronary sinus dissection, pneumothorax, pocket bleeding requiring drainage, worsening tricuspid valve function, vegetation embolization, venous thrombosis, requirement of blood transfusion or lead migration). Results Comparing first time extractions vs repeat extractions, there was no significant difference in proportion of patients of female gender (32.4% vs. 28.3%, p=0.412), patients with prior CABG (23.0 vs. 23.4%, p=0.227), HTN (66.0% vs. 62.2%, p=0.462), HF (52.3% vs. 62.0%), HLD (39.6% vs 39.7%, p=0.682), DM (35.3% vs. 30.8%, p=0.387), or CAD (55.9% vs 56.0%, p=0.978). There was no significant difference in major complications (1.4% vs. 1.0%, p=0.749) and minor complications (3.5% vs 4.1%, p=0.741). Conclusion Patients undergoing repeat lead extractions showed very similar baseline demographics compared to first time lead extractions. Repeat extractions did not have increased rates of major or minor complications.

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