A cardiac implantable electronic device (CIED) may have implanted leads. Removal of these leads may be associated with perforation of the ventricular and/or vascular wall. The authors are from multiple institutions in Canada.
Patient selection: extraction of implanted cardiac leads
Indications for lead extraction included one or more of the following:
(1) infection (82% pocket infection; 11% endocarditis)
(2) lead malfunction or dysfunction
(3) vascular access
(4) device upgrade
(5) skin erosion
Predictors of perforation:
(1) female sex (OR 3.3)
(2) diabetes (OR 2.1)
(3) no history of previous cardiac surgery (OR 3.3)
(4) left ventricular ejection fraction (LVEF) >= 40% (OR 2.8)
(5) >= 2 leads extracted (OR 2.5)
(6) oldest lead age > 8 years (OR 2.6)
Predictors of 30-day mortality:
(1) older age (OR 1.04)
(2) anemia (hemoglobin < 130 g/L for male; hemoglobin < 120 g/L for female; OR 3.1)
(3) infection as indication for lead extraction (OR 3.9)
