A Retrospective Analysis Of Transvenous Leads Extraction Of Cardiac Implantable Electronic Devices

Objectives : Analyzing transvenous lead extraction outcomes and screening for complication risk factors in transvenous lead extraction patients.Method:Retrospective analysis of clinical data of patients who attended the First Affiliated Hospital of Xinjiang Medical University from January 2016 to December 2021 and underwent transvenous lead extracted for various reasons.The binary logistic regression analysis method was used to analyze the two groups of variables by single-factor logistic regression analysis.Then,the variables with p-value less than 0.2 and the variables confirmed by literature research are included in the multivariate logistic regression analysis,and the forward stepwise regression method is selected to screen the risk factors.Result:Of the 69 patients who underwent transvenous lead removal,the mean age was 65.58 ± 12.97 years and 41.9%were female.There were 20(29%)cases of capsular bag infection,18(26.1%)cases of abnormal parameters or updated CIED devices,and 36(44.9%)cases of lead-related complications.A total of 94 leads were removed,with a mean lead implantation duration of 19.00(5.0,95.50)months and a maximum implantation duration of 314 months.The success rate of complete lead extraction was 97.1% and the clinical extraction success rate was 100%.Six patients experienced complications during extraction,with a complication rate of 8.7%.Univariate and multifactorial logistic regression analysis showed that initial lead implantation time ≥10 years increased the risk of complications in TLE surgery(OR=9.054 95%CI 1.214 ～ 67.518,P=0.032).Conclusion: Transvenous lead extraction is currently the primary means of managing CIED lead-related complications with high safety and efficacy.The risk of TLE procedure complications is increased when the initial CIED lead implantation time is ≥10 years.