title: Lead extraction outcomes in patients with congenital heart disease.
abstract: OBJECTIVE
  Patients with congenital heart disease (CHD) are at increased risk for intracardiac device malfunction and infection that may necessitate extraction; however, the risk of extraction is poorly understood. This study addresses the safety of extraction in patients with structural heart disease and previous cardiac surgery.
  
  
  RESULTS
  This retrospective study included 40 CHD and 80 matched control patients, who underwent transvenous lead extractions between 2001 and 2014. Only leads >12 months were included. There were 77 leads in CHD patients and 146 in controls. The mean age was 38 ± 16 years in CHD patients. Ninety per cent of CHD patients had ≥1 cardiac surgeries when compared with 21% of controls (P < 0.001). The number of abandoned leads was significantly different (17 vs. 3, P < 0.001). Lead age was similar with an average duration of 83 ± 87 months in CHD patients and 62 ± 65 months in controls (P = 0.24). There was no significant difference in extraction techniques. Manual traction was successful in 40% of CHD patients and 47% of controls, and advanced techniques were used in 60 and 53% of CHD patients and controls, respectively. Complete extraction was achieved in 94% of the patients in both groups. There was no significant difference in complications.
  
  
  CONCLUSIONS
  Lead extraction can be safely performed in patients with CHD. Despite anatomic abnormalities and longer implantation times, the difficulty of lead extraction in patients with CHD is comparable with controls.
authors.affiliation: Mayo Clinic, St. Mary's Campus, Mail Code RO MB 04 506CAR, 1216 2nd St SW, Rochester, MN 55902, USA.
authors.forename: Erin A
authors.initials: EA
authors.lastname: Fender
authors.affiliation: Mayo Clinic, St. Mary's Campus, Mail Code RO MB 04 506CAR, 1216 2nd St SW, Rochester, MN 55902, USA.
authors.forename: Ammar M
authors.initials: AM
authors.lastname: Killu
authors.affiliation: Mayo Clinic, St. Mary's Campus, Mail Code RO MB 04 506CAR, 1216 2nd St SW, Rochester, MN 55902, USA.
authors.forename: Bryan C
authors.initials: BC
authors.lastname: Cannon
authors.affiliation: Mayo Clinic, St. Mary's Campus, Mail Code RO MB 04 506CAR, 1216 2nd St SW, Rochester, MN 55902, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Friedman
authors.affiliation: Mayo Clinic, St. Mary's Campus, Mail Code RO MB 04 506CAR, 1216 2nd St SW, Rochester, MN 55902, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Mcleod
authors.affiliation: Mayo Clinic, St. Mary's Campus, Mail Code RO MB 04 506CAR, 1216 2nd St SW, Rochester, MN 55902, USA.
authors.forename: David O
authors.initials: DO
authors.lastname: Hodge
authors.affiliation: Oregon Health and Science University, Knight Cardiovascular Institute, Mail Code UHN-62 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA.
authors.forename: Craig S
authors.initials: CS
authors.lastname: Broberg
authors.affiliation: Oregon Health and Science University, Knight Cardiovascular Institute, Mail Code UHN-62 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Henrikson
authors.affiliation: Mayo Clinic, St. Mary's Campus, Mail Code RO MB 04 506CAR, 1216 2nd St SW, Rochester, MN 55902, USA.
authors.forename: Yong-Mei
authors.initials: YM
authors.lastname: Cha
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002648:Child; D017147:Defibrillators, Implantable; D020878:Device Removal / Q000009:adverse effects; D004554:Electric Countershock / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009922:Oregon; D010138:Pacemaker, Artificial; D011183:Postoperative Complications / Q000209:etiology; D011475:Prosthesis Failure; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018754:Ventricular Dysfunction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D055815:Young Adult
keywords: Cardiac implantable electronic device; Congenital heart disease; Laser lead extraction; Lead extraction