title: Outcomes of lead extraction in young adults.
abstract: Extraction of pacemaker and defibrillator leads in young adults may be technically challenging because of more extensive fibrosis and calcification in this patient population.
  
  
  
  The purpose of this study was to examine outcomes of lead extraction (LE) in young adults at our institution.
  
  
  
  We retrospectively identified all patients who underwent LE at our institution between January 1, 2007, and May 31, 2016. Patients were divided by age into 2 groups: <40 years (group 1, n = 84) or ≥40 years (group 2, n = 690). Outcomes were determined by medical records review.
  
  
  
  Patients in group 2 had a higher overall average number of leads extracted per procedure compared to group 1 (1.64 ± 0.80 vs 1.45 ± 0.64; P <.001). Lead dwell time was similar in the 2 groups (5.7 ± 5 years vs 5.6 ± 4.3 years; P = .95). The younger cohort tended to require femoral extraction techniques more frequently (9.5% vs 4.4%; P = .055). Extraction procedural success (group 1: 94.1%, group 2: 94.9%; P = .792), major complications (group 1: 0%, group 2: 1.3%; P = 1), and periprocedural mortality (group 1: 0%, group 2: 0.86%; P = 1) were similar in the 2 groups.
  
  
  
  LE can be performed safely and effectively in young adults. Despite the lower number of leads extracted per procedure and the similar lead dwell time, younger adults more frequently required the use of femoral extraction tools, thus highlighting the importance of performing these procedures in centers with advanced expertise in extraction techniques.
authors.affiliation: Department of Medicine, Division of Cardiology, Section of Electrophysiology, Emory University School of Medicine, Atlanta, Georgia. Electronic address: melcham@emory.edu.
authors.forename: Mikhael F
authors.initials: MF
authors.lastname: El-Chami
authors.affiliation: Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Sayegh
authors.affiliation: Emory University, Atlanta, Georgia.
authors.forename: Adarsh
authors.initials: A
authors.lastname: Patel
authors.affiliation: Georgia State University, Atlanta, Georgia.
authors.forename: Jad
authors.initials: J
authors.lastname: El-Khalil
authors.affiliation: Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Yaanik
authors.initials: Y
authors.lastname: Desai
authors.affiliation: Department of Medicine, Division of Cardiology, Section of Electrophysiology, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Angel R
authors.initials: AR
authors.lastname: Leon
authors.affiliation: Department of Medicine, Division of Cardiology, Section of Electrophysiology, Emory University School of Medicine, Atlanta, Georgia.
authors.forename: Faisal M
authors.initials: FM
authors.lastname: Merchant
mesh_terms: D000328:Adult; D000367:Age Factors; D006328:Cardiac Catheterization / Q000379:methods; D002406:Catheterization, Peripheral / Q000379:methods*; D017147:Defibrillators, Implantable / Q000009:adverse effects / Q000706:statistics & numerical data; D020878:Device Removal / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D004868:Equipment Failure; D005260:Female; D005268:Femoral Vein / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: Congenital heart disease; Femoral extraction; Lead extraction; Outcomes; Young adults