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Associated factors and outcomes of crossover from a laser sheath to a bidirectional rotational mechanical sheath during transvenous lead extraction.
- Source :
- Journal of Arrhythmia; Dec2023, Vol. 39 Issue 6, p947-955, 9p
- Publication Year :
- 2023
-
Abstract
- Background: During transvenous lead extraction (TLE), a GlideLight laser sheath (Philips) cannot always be advanced over the lead, and crossover to the Evolution system (i.e., an Evolution RL sheath or Evolution Shortie RL sheath [Cook Medical]) is required. We aimed to determine the associated factors and outcomes of such device crossover. Methods: This observational study included 112 patients who underwent TLE. The patients were divided into crossover and non‐crossover groups. Outcomes and associated factors of crossover were evaluated. Results: Overall, 57 (50.9%) patients required crossover to the Evolution system (crossover group), whereas 55 (49.1%) patients did not require crossover (non‐crossover group). Clinical success rate was similar between the two groups (98.3% vs. 100%; p = 1.00). No major intraprocedural complications related to powered sheaths occurred. Multivariate logistic regression analysis results showed that dwell time of the oldest extracted lead (per year) (odds ratio [OR]: 1.18, 95% confidence interval [CI]: 1.02–1.36; p =.026), number of leads extracted per procedure (OR: 7.23, 95% CI: 1.74–29.99; p =.007), and use of a femoral approach (OR: 21.09, 95% CI: 2.33–190.67; p =.007) were associated factors of crossover. The cutoff for crossover was 7.7 years from the implant (sensitivity 90.5%, specificity 64.9%, area under the curve 0.80). Conclusions: Both groups showed a high rate of clinical success. Switching to the Evolution system may facilitate a safe and effective TLE when a laser sheath does not advance despite laser activation. [ABSTRACT FROM AUTHOR]
- Subjects :
- LASER therapy
ELECTRODES
ECHOCARDIOGRAPHY
BLOOD
STATISTICS
MEDICAL device removal
SCIENTIFIC observation
CONFIDENCE intervals
CHEST X rays
CELL culture
MULTIPLE regression analysis
MULTIVARIATE analysis
ARTIFICIAL implants
IMPLANTABLE cardioverter-defibrillators
RETROSPECTIVE studies
VENOGRAPHY
MANN Whitney U Test
FISHER exact test
TREATMENT effectiveness
COMPARATIVE studies
ELECTROCARDIOGRAPHY
STATISTICAL hypothesis testing
CARDIAC pacemakers
ODDS ratio
SENSITIVITY & specificity (Statistics)
SPIROMETRY
LOGISTIC regression analysis
DATA analysis software
ABLATION techniques
Subjects
Details
- Language :
- English
- ISSN :
- 18832148
- Volume :
- 39
- Issue :
- 6
- Database :
- Supplemental Index
- Journal :
- Journal of Arrhythmia
- Publication Type :
- Academic Journal
- Accession number :
- 173973215
- Full Text :
- https://doi.org/10.1002/joa3.12929