Transvenous Lead Extraction Outcomes in Hemodialysis Patients: Markers for Increased Mortality
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| Format: | Artículo Open Access |
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Wiley
2025
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| author | Aritra Paul Katsuhide Hayashi Kashyap Bodi Bryan Baranowski Arshneel Kochar David Martin Tyler Taigen John Rickard Ayman Hussein Oussama Wazni Thomas Callahan |
| author_facet | Aritra Paul Katsuhide Hayashi Kashyap Bodi Bryan Baranowski Arshneel Kochar David Martin Tyler Taigen John Rickard Ayman Hussein Oussama Wazni Thomas Callahan Aritra Paul Katsuhide Hayashi Kashyap Bodi Bryan Baranowski Arshneel Kochar David Martin Tyler Taigen John Rickard Ayman Hussein Oussama Wazni Thomas Callahan |
| collection | Wiley Open Access |
| contents | Transvenous Lead Extraction Outcomes in Hemodialysis Patients: Markers for Increased Mortality Aritra Paul Katsuhide Hayashi Kashyap Bodi Bryan Baranowski Arshneel Kochar David Martin Tyler Taigen John Rickard Ayman Hussein Oussama Wazni Thomas Callahan Journal of Cardiovascular Electrophysiology ABSTRACT Background The increasing use of cardiac implantable electronic devices (CIEDs) has led to a progressive increase in transvenous lead extraction (TLE) procedures. Due to immune compromise and systemic dysfunction, hemodialysis (HD) patients face higher risks of device‐related infection and need for TLE. Objectives This study evaluates TLE outcomes in dialysis patients and identifies predictors of 30‐day all‐cause mortality (ACM). Subgroup analysis focuses on dialysis patients undergoing TLE for infectious indications to determine predictors of adverse outcomes. Methods A retrospective review of TLE procedures performed from 2013 to 2022 ( n = 1614) identified 53 patients (3.3%) on HD. Procedural outcomes and 30‐day ACM were compared between HD and non‐HD cohorts using chi‐square tests. Predictors of 30‐day ACM were assessed with Cox regression. For HD patients with infectious indications ( n = 48), preprocedural findings, including pocket infection, positive blood cultures, and intracardiac mass, were evaluated for their impact on outcomes. Results Procedural success and complication rates were similar between HD and non‐HD groups, but 30‐day ACM was significantly higher in HD patients (13.2% vs. 2%; p < 0.001). Independent predictors of 30‐day ACM included HD, infectious indication for TLE, and NYHA Class 3/4 symptoms. Among HD patients with infectious indications, visualization of intracardiac mass on echocardiography predicted higher 30‐day ACM (33.3% vs. 6.1%; p = 0.01) and was confirmed as an independent predictor (OR 24.88; 95% CI 1.7–374.3; p = 0.02). Conclusion Dialysis is an independent predictor of 30‐day ACM after TLE. In dialysis patients with infectious indications, intracardiac mass is a prognostic factor for adverse outcomes. 10.1111/jce.70113 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1111/jce.70113 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_jce_70113 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Transvenous Lead Extraction Outcomes in Hemodialysis Patients: Markers for Increased Mortality Aritra Paul Katsuhide Hayashi Kashyap Bodi Bryan Baranowski Arshneel Kochar David Martin Tyler Taigen John Rickard Ayman Hussein Oussama Wazni Thomas Callahan Journal of Cardiovascular Electrophysiology Transvenous Lead Extraction Outcomes in Hemodialysis Patients: Markers for Increased Mortality Aritra Paul Katsuhide Hayashi Kashyap Bodi Bryan Baranowski Arshneel Kochar David Martin Tyler Taigen John Rickard Ayman Hussein Oussama Wazni Thomas Callahan Journal of Cardiovascular Electrophysiology ABSTRACT Background The increasing use of cardiac implantable electronic devices (CIEDs) has led to a progressive increase in transvenous lead extraction (TLE) procedures. Due to immune compromise and systemic dysfunction, hemodialysis (HD) patients face higher risks of device‐related infection and need for TLE. Objectives This study evaluates TLE outcomes in dialysis patients and identifies predictors of 30‐day all‐cause mortality (ACM). Subgroup analysis focuses on dialysis patients undergoing TLE for infectious indications to determine predictors of adverse outcomes. Methods A retrospective review of TLE procedures performed from 2013 to 2022 ( n = 1614) identified 53 patients (3.3%) on HD. Procedural outcomes and 30‐day ACM were compared between HD and non‐HD cohorts using chi‐square tests. Predictors of 30‐day ACM were assessed with Cox regression. For HD patients with infectious indications ( n = 48), preprocedural findings, including pocket infection, positive blood cultures, and intracardiac mass, were evaluated for their impact on outcomes. Results Procedural success and complication rates were similar between HD and non‐HD groups, but 30‐day ACM was significantly higher in HD patients (13.2% vs. 2%; p < 0.001). Independent predictors of 30‐day ACM included HD, infectious indication for TLE, and NYHA Class 3/4 symptoms. Among HD patients with infectious indications, visualization of intracardiac mass on echocardiography predicted higher 30‐day ACM (33.3% vs. 6.1%; p = 0.01) and was confirmed as an independent predictor (OR 24.88; 95% CI 1.7–374.3; p = 0.02). Conclusion Dialysis is an independent predictor of 30‐day ACM after TLE. In dialysis patients with infectious indications, intracardiac mass is a prognostic factor for adverse outcomes. 10.1111/jce.70113 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Transvenous Lead Extraction Outcomes in Hemodialysis Patients: Markers for Increased Mortality |
| topic | Journal of Cardiovascular Electrophysiology |
| url | https://onlinelibrary.wiley.com/doi/10.1111/jce.70113 |