Safety and effectiveness of transvenous lead extraction in octogenarians

As the median population ages, the number of elderly patients with implantable cardiac devices referred for transvenous lead extraction will dramatically increase. The safety and effectiveness of lead extraction in elderly patients has not been well evaluated. We report the safety and effectiveness of transvenous lead extraction in octogenarians.

From January 2002 to December 2013, we reviewed data from consecutive patients more than 80 years referred to our institution for transvenouslead extraction for infection or lead dysfonction.

Clinical characteristics, procedural features, and periprocedural major and minor complications were compared between octogenarians and younger patients. Out of 391 patients undergoing lead extraction during the study period, 100 (25,6%) patients were octogenarians (mean age 84,24 years; range 80-98; 75 % males).

A significantly higher percentage of octogenarians presented with chronic renal failure (P=0,03), history of malignancy (P =0,04)

Infection was the most common reason for lead extraction in elderly (82% of cases).Laser assistance for extraction was recquired in 69 elderly patients (69%)

Complete lead extraction efficacy were similar between both groups (99% in octogenarians vs 98,6% in patients <80 years; P =0,6).

No deaths occurred in the octogenarian group. No differences in terms of other periprocedural major and minor complications were found between the 2 groups.

Despite a significantly higher rate of comorbidities, transvenouslead extraction can be performed safely and successfully in octogenarians with a low rate of complications