Effect of Age on In-Hospital Outcomes of Transvenous Lead Extraction for Infected Cardiac Implantable Electronic Device
Document Type
Conference Proceeding
Publication Date
5-2024
Publication Title
Heart Rhythm
Abstract
Background: The real-world data on the safety profile of transvenous lead extraction (TLE) for infected cardiac implantable electronic devices (CIED) among elderly patients is not well-established. Objective: This study aimed to evaluate the hospital outcomes between patients of different age groups who underwent TLE for infected CIED. Methods: Using the Nationwide Readmissions Database, our study included patients aged ≥18 years who underwent TLE for infected CIED between 2017 and 2020. We divided the patients into four groups: Group A. Young (,50 years), Group B. Young intermediate (50 - 69 years old), Group C. Older intermediate (70 - 79 years old), and Group D. Octogenarian (≥80 years old). We then analyzed the in-hospital outcome between these age groups. Results: A total of 5,712 patients who were admitted for TLE of infected CIED were included in this study: 982 (9.0%) patients in group A, 4,234 (38.7%) patients in group B, 3,204 (29.3%) patients in group C and 2,508 (23.0%) of patients in group D. Post-procedurally, the risk of early mortality increased with older age (Group B vs Group A: OR: 1.92, 95% CI: 1.19-3.09, p,0.01; Group C vs Group A: OR: 2.47, 95% CI: 1.51-4.04, p,0.01; Group D vs Group A: OR: 2.82, 95% CI: 1.69-4.72, p,0.01). The risk of non-home discharge also increased in elderly groups (Group B vs Group A: OR: 1.89; 95% CI: 1.52-2.36; p,0.01; Group C vs Group A: OR: 2.82; 95% CI 2.24-3.56; p,0.01; Group D vs Group A: OR: 4.16; 95% CI: 3.28-5.28; p,0.01). There was no significant difference in hospitalization length and 30-day readmission between different age groups. Apart from a higher rate of open-heart surgery in group A, the procedural complications were comparable between these age groups. Among the reported deaths, 66% occurred greater than seven days from TLE procedure. Conclusion: Our study suggests that elderly patients have poorer in-hospital outcomes following TLE for infected CIED. However, elderly patients do not have a higher risk of procedural complications. These emphasize the similar safety profile of TLE for infected CIED in patients of different ages but also highlight the importance of the need for careful post-TLE management in these elderly patients.
Volume
21
Issue
5S
First Page
S664
Last Page
S665
Recommended Citation
Tan MC, Ang QX, Yeo YH, THong JY, Tolat AV, Scott LR, et al. Effect of age on in-hospital outcomes of transvenous lead extraction for infected cardiac implantable electronic device. Heart Rhythm. 2024 May;21(5S):S664-S665. doi: 10.1016/j.hrthm.2024.03.1637
DOI
10.1016/j.hrthm.2024.03.1637
Comments
Heart Rhythm Society Annual Meeting, May 16-19, 2024, Boston, MA