title: Percutaneous extraction of cardiac implantable electronic devices (CIEDs) in octogenarians.
abstract: BACKGROUND
  As the population receiving cardiac device therapy ages, the number of extraction procedures performed in octogenarians is increasing. This group has more comorbidities and may be at higher risk of such procedures.
  
  
  OBJECTIVE
  Document the safety and success of percutaneous lead extraction in octogenarians.
  
  
  METHODS
  All extraction cases performed between January 2001 and April 2011 entered into a computer database were analyzed for patient characteristics and indications, extraction technique, procedural success, and complications. Success and complications were classified according to the Heart Rhythm Society consensus statement. Outcomes in octogenarians were compared to younger patients undergoing extraction during the same period.
  
  
  RESULTS
  Four hundred and six cases were performed: 72 procedures in octogenarians (mean age 84, range 80-95) and 334 in younger adults (mean age 62, range 20-79). Octogenarians had a greater number of comorbidities per case. Infection was the commonest indication for extraction in both groups. One hundred forty-one leads were extracted in octogenarians and 657 in younger patients. Laser assistance was required in 51.4% of octogenarians versus 49.7% of younger patients. Procedural success was achieved in 71/72 (98.6%) octogenarians versus 329/334 (98.5%) younger patients. No procedural mortality occurred in either group. Overall, complications were more frequent in octogenarians with major and minor complications occurring in 2.8 and 8.3% of octogenarians versus 0.6 and 3.0% of younger patients (P = 0.014).
  
  
  CONCLUSIONS
  Procedural success was equally high in octogenarians and younger patients. Percutaneous lead extraction can be performed effectively and safely in octogenarians and is associated with a higher complication rate but no increased mortality.
authors.affiliation: St. Thomas' Hospital, Department of Cardiology, London, UK. stevenwilliams@nhs.net
authors.forename: Steven E
authors.initials: SE
authors.lastname: Williams
authors.forename: Aruna
authors.initials: A
authors.lastname: Arujuna
authors.forename: John
authors.initials: J
authors.lastname: Whitaker
authors.forename: Manav
authors.initials: M
authors.lastname: Sohal
authors.forename: Anoop K
authors.initials: AK
authors.lastname: Shetty
authors.forename: Debashis
authors.initials: D
authors.lastname: Roy
authors.forename: Julian
authors.initials: J
authors.lastname: Bostock
authors.forename: Michael
authors.initials: M
authors.lastname: Cooklin
authors.forename: Jaswinder
authors.initials: J
authors.lastname: Gill
authors.forename: Mark
authors.initials: M
authors.lastname: O'Neill
authors.forename: Matthew
authors.initials: M
authors.lastname: Wright
authors.forename: Nikhil
authors.initials: N
authors.lastname: Patel
authors.forename: Cliff
authors.initials: C
authors.lastname: Bucknall
authors.forename: Shoaib
authors.initials: S
authors.lastname: Hamid
authors.forename: C Aldo
authors.initials: CA
authors.lastname: Rinaldi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D020878:Device Removal / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000401:mortality*; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000401:mortality*; D015995:Prevalence; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology