Device lead extraction safe for young in specialist centres

16th March 2017

Researchers have been looking into the safety of extracting old leads for pacemakers and internal defibrillators when fitting new devices.

The leads, which go into the heart, can be difficult to remove, especially in younger people, because of fibrosis and calcification.

Doctors in Atlanta in America decided to investigate how the removals went in their younger patients compared to older ones.

So they examined the outcomes for patients under 40 in one group and those aged 40 and over in another.

They looked at all the medical records of their patients who had had device lead extraction between January 1, 2007, and May 31, 2016. There were 84 patients under 40 and 690 were 40 or over.

Patients in older group had a higher overall average number of leads extracted per procedure compared to the younger people. Most had had their leads in place for around ten years. The younger patients tended to require their leads being extracted via the femoral vein rather than the implant vein.

However, the leads were extracted successfully in both groups (in over 94 per cent of cases). There were no major complications or post-surgery deaths in the younger group and only around one per cent in the older group.

The researchers, from the Emory University School of Medicine and Georgia State University, concluded that lead extraction can be performed safely and effectively in young adults. But as younger adults more frequently required the use of femoral extraction tools, it was important the treatment was performed in centres with advanced expertise in extraction techniques.

For more details, see here.