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Procedural outcomes and long-term survival following trans-venous defibrillator lead extraction in patients with end-stage renal disease.
- Source :
- EP: Europace; Dec2017, Vol. 19 Issue 12, p1994-2000, 7p
- Publication Year :
- 2017
-
Abstract
- <bold>Aims: </bold>End-stage renal disease (ESRD) increases the risk of implantable cardioverter-defibrillator (ICD) infection. We sought to define outcomes of lead extraction in patients with ESRD.<bold>Methods and Results: </bold>Implantable cardioverter-defibrillator lead extractions at our institution from January 2006 to March 2014 were stratified by absence (Control-Ex, n = 465) or presence (ESRD-Ex, n = 43) of ESRD. Procedural outcomes and survival were determined by medical records review. Survival in the ESRD-Ex group was compared with a contemporaneous cohort with ESRD undergoing ICD lead implantation (ESRD-I, n = 127). Among extraction patients, those with ESRD were more likely to be extracted for infection (74.4% vs. 28.6%, P < 0.001). Extraction procedure success (Control-Ex: 97% vs. ESRD-Ex: 93%, P = 0.17) and procedural deaths (Control-Ex: 1.1% vs. ESRD-Ex: 2.3%, P = 0.413) were similar. Survival 1 year following extraction was worse in the ESRD-Ex group compared with the Control-Ex, with a survival rate of 65.6% vs. 92.6% (P < 0.001); these curves continued to diverge through year 3. One-year survival in the ESRD-Ex group was worse than among ESRD patients undergoing ICD implant (ESRD-I), but these curves converged and survival was similar by year 3.<bold>Conclusions: </bold>Implantable cardioverter-defibrillator lead extraction can be performed safely and effectively in patients with ESRD. However, despite high rates of procedural success, long-term mortality following extraction in ESRD patients is substantial. Much of the long-term mortality risk appears to be accounted for by the presence of ESRD and an indication for an ICD. [ABSTRACT FROM AUTHOR]
- Subjects :
- CHRONIC kidney failure complications
CHRONIC kidney failure
COMPARATIVE studies
ELECTRIC countershock
IMPLANTABLE cardioverter-defibrillators
INFECTION
RESEARCH methodology
MEDICAL cooperation
COMPLICATIONS of prosthesis
RESEARCH
RISK assessment
TIME
EVALUATION research
TREATMENT effectiveness
RETROSPECTIVE studies
MEDICAL device removal
KAPLAN-Meier estimator
DIAGNOSIS
EQUIPMENT & supplies
Subjects
Details
- Language :
- English
- ISSN :
- 10995129
- Volume :
- 19
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- EP: Europace
- Publication Type :
- Academic Journal
- Accession number :
- 126560419
- Full Text :
- https://doi.org/10.1093/europace/euw367