Efficacy and safety of transvenous lead extraction in the Chinese octogenarian patients

Background Managing elderly patients with infection or malfunction deriving from a cardiac implantable electronic device (CIED) may be challenging. We report the safety and effectiveness of transvenous lead extraction in Chinese octogenarian patients. Hypothesis Transvenous lead extraction can be performed safely and successfully in the Chinese octogenarians. Methods We retrospectively identified all patients who underwent TLE at our institution between March 2013 and January 2021. This population was divided into the following two groups based solely on age: octogenarians and non-octogenarians. These two groups were compared on the basis of several characteristics and clinical outcomes. Results Consecutive 1106 patients were analyzed, including 184 (16.6%) octogenarians and 922(83.4%) non-octogenarians. The octogenarians presented more comorbidities. A total of 378 leads and 2004 leads were removed from the patients in the octogenarian group and non-octogenarian group, respectively. The mean lead implant duration was 6.1 +/- 5.1 and 5.8 +/- 4.6 years for octogenarians and non-octogenarians (p = 0.296). The majority of the patients in both groups underwent TLE through the femoral approach (67.5% vs 61.6%, p = 0.14). The complete procedure success rate was similar between the octogenarian and non-octogenarian group (96.7% vs.95.3%, p = 0.39). There were no differences with respect to the proportion of minor, major complications and deaths. Long-term mortality (median time 3.3 years) after TLE in octogenarians was significantly higher compared with younger individuals. Conclusions At experienced centers, transvenous lead extraction can be performed safely in Chinese octogenarians with procedural success rate and complication rate comparable to younger individuals.