Feasibility and safety of a transvenous lead extraction program implementation in South America: Challenges, early outcomes, and global collaboration-A single-center experience

Pablo Salazar; Armando Pérez-Silva; Alex Villablanca; Francisco Bello; Osvaldo Pérez; Andrew Beaser; Hemal Nayak

doi:10.1016/j.hroo.2022.07.012

Feasibility and safety of a transvenous lead extraction program implementation in South America: Challenges, early outcomes, and global collaboration-A single-center experience

Heart Rhythm O2. 2022 Dec 16;3(6Part B):731-735. doi: 10.1016/j.hroo.2022.07.012. eCollection 2022 Dec.

Authors

Pablo Salazar¹, Armando Pérez-Silva¹, Alex Villablanca¹, Francisco Bello¹, Osvaldo Pérez¹, Andrew Beaser², Hemal Nayak²

Affiliations

¹ Department of Cardiology, Electrophysiology Division, Hospital las Higuera's, Talcahuano, Chile.
² Department of Cardiology, Center for Arrhythmia Care, The University of Chicago, Pritzker School of Medicine, Chicago, Illinois.

Abstract

Background: Transvenous lead extraction is the standard of care for cardiac implantable electronic device (CIED) malfunction/infection-related removal. However, data on its performance and results in underdeveloped countries are limited.

Objective: The purpose of this study was to report the feasibility and efficacy of a lead extraction program in a tertiary hospital in Chile, South America.

Methods: Patients requiring CIED removal at the Electrophysiology Division of the Hospital las Higuera's were retrospectively analyzed. Outcomes including procedure-related mortality, procedural success and failure, and cardiac and vascular complications were reported.

Results: A total of 15 patients were analyzed (median age 68 [interquartile range 52-75] years; 80% male). Patients with lead extraction difficulty index >10 represented 33% of patients. Infection was the indication for removal in all patients, with pocket infection (80%). Mechanical rotational tools were used in 66% of cases, and a total of 29 leads were removed. Procedural success was accomplished in 93% of cases. There was 1 (7%) intraprocedural complication and no procedure-related mortality.

Conclusions: The development of a lead management program is feasible, safe, and effective in underdeveloped countries.

Keywords: Electrophysiology; Lead complications; Lead extraction; Lead management; South America.