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  3. Impact of a structured institutional lead management programme at a high volume centre for transvenous lead extractions in Switzerland
 

Impact of a structured institutional lead management programme at a high volume centre for transvenous lead extractions in Switzerland

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BORIS DOI
10.48350/181887
Date of Publication
January 2023
Publication Type
Article
Division/Institute

Universitätsklinik fü...

Universitätsklinik fü...

Universitätsklinik fü...

Contributor
Häberlin, Andreas David Heinrichorcid-logo
Universitätsklinik für Kardiologie
sitem Zentrum für Translationale Medizin und Biomedizinisches Unternehmertum
Holz, Alexander
Seiler, Jens
Universitätsklinik für Kardiologie
Baldinger, Samuel Hannesorcid-logo
Universitätsklinik für Kardiologie
Tanner, Hildegard
Universitätsklinik für Kardiologie
Roten, Laurentorcid-logo
Universitätsklinik für Kardiologie
Madaffari, Antonio
Universitätsklinik für Kardiologie
Servatius, Helge Simon
Universitätsklinik für Kardiologie
Jenni, Hansjoerg
Universitätsklinik für Herzchirurgie
Kadner, Alexander
Universitätsklinik für Herzchirurgie
Erdoes, Gabor
Universitätsklinik für Anästhesiologie und Schmerztherapie
Reichlin, Tobias Romanorcid-logo
Universitätsklinik für Kardiologie
Noti, Fabian
Universitätsklinik für Kardiologie
Subject(s)

600 - Technology::610...

Series
Cardiovascular medicine
ISSN or ISBN (if monograph)
1423-5528
Publisher
EMH Swiss Medical Publishers Ltd
Language
English
Publisher DOI
10.4414/cvm.2022.02224
Description
BACKGROUND: Transvenous lead extraction (TLE) is the recommended management strategy for a variety of cardiac implantable electronic device (CIED) infections, malfunctions and other conditions. Large registries have established the safety and efficacy of TLE per se but temporal outcome data after the introduction of an institutional lead management programme remain scarce.

OBJECTIVE: To investigate the impact of a structured institutional lead management programme on TLE outcomes.

METHODS: All patients who underwent TLE at our institution between January 2013 and December 2020 were included. We assessed procedural outcomes after TLE for two separate time periods: from January 2013 to December 2018 and January 2019 to December 2020 (after introduction of a structured institutional lead management programme).

RESULTS: In 2013–2018, the median number of TLE procedures per year at our centre was 14 (range 10–19, total 84). In 2019/2020, the median number of interventions per year increased to 46 (range 41–51, total 92). Noninfectious indications for TLE became more frequent (p <0.001), and the proportion of TLEs due to infections decreased. Median lead dwell time was not different (4.3 years [2013–2018] vs 4.4 years [2019–2020], p = 0.43). Clinical success rates improved from 90% to 98% (p = 0.020) and complete procedural success increased from 85% to 95% (p = 0.027). There was a trend towards a lower number of TLE-associated complications (p = 0.07).

CONCLUSION: A structured institutional lead management programme and increasing experience significantly improve TLE outcomes. TLE can be safely performed in high-volume centres, allowing for a more liberal extraction policy, including in the case of non-infectious TLE indications.
Handle
https://boris-portal.unibe.ch/handle/20.500.12422/166598
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cvm_2022_02224.pdftextAdobe PDF416.77 KBpublishedOpen
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