title: Safety and effectiveness of transvenous extraction of pacemaker and implantable cardioverter-defibrillator leads in patients under or over 80 years of age.
abstract: BACKGROUND
  Progressive aging of the population and the increasing number of complications of electrotherapy procedures are the main reasons of a remarkable increase in the number of transvenous extraction procedures of pacemaker (PM) and implantable cardioverter-defibrillator (ICD) leads in the elderly patients.
  
  
  OBJECTIVE
  To assess the safety and effectiveness of such procedures in patients under or over 80 years of age. The study included all patients who underwent transvenous PM/ICD lead extraction in 2003-2011.
  
  
  METHODS
  All patients were divided into two groups based on their age at the time of the procedure: group A included patients under 80 years of age (134 patients; 97 male, 37 female) and group B included patients over 80 years of age (26 patients; 16 male, 10 female).
  
  
  RESULTS
  No differences were found between the two groups in terms of gender proportions, comorbidities, New York Heart Association (NYHA) functional class, and left ventricular ejection fraction. In total, 220 leads were removed (group A: 63 defibrillating and 122 pacing leads, group B: 2 defibrillating and 33 pacing leads). The most common indication for the lead removal procedure in both groups was infection, either in the form of PM/ICD pocket infection (46 and 13 cases, respectively) or infective endocarditis (18 and 2 cases, respectively). Procedural outcomes in both groups were not statistically different in terms of the final outcome or complication rates. The results in groups A and B were as follows: complete success 95.5% vs. 96.2%, respectively, clinical success 3% vs. 3.8%, respectively, and failure 1.5% vs. 0%, respectively, with no significant differences between the groups. No major complications of the procedure were observed in either of the groups.
  
  
  CONCLUSIONS
  Our findings indicate that transvenous extraction of PM/ICD leads appears to be a safe and effective procedure both in relatively younger patients and in patients over 80 years of age.
authors.affiliation: Department of Cardiology and Electrotherapy, Medical University of Gdansk, Poland. kempa@gumed.edu.pl
authors.forename: Maciej
authors.initials: M
authors.lastname: Kempa
authors.forename: Szymon
authors.initials: S
authors.lastname: Budrejko
authors.forename: Marta
authors.initials: M
authors.lastname: Piepiorka
authors.forename: Jan
authors.initials: J
authors.lastname: Rogowski
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Raczak
authors.forename: Dariusz
authors.initials: D
authors.lastname: Kozłowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017147:Defibrillators, Implantable / Q000009:adverse effects; D020878:Device Removal / Q000379:methods*; D004567:Electrodes, Implanted / Q000009:adverse effects; D004696:Endocarditis / Q000209:etiology / Q000601:surgery; D004868:Equipment Failure; D019544:Equipment Failure Analysis; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000601:surgery*; D006321:Heart; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects; D016896:Treatment Outcome