Procedural outcomes and long-term survival following trans-venous defibrillator lead extraction in patients with end-stage renal disease.
Europace
; 19(12): 1994-2000, 2017 Dec 01.
Article
em En
| MEDLINE
| ID: mdl-28065887
ABSTRACT
AIMS:
End-stage renal disease (ESRD) increases the risk of implantable cardioverter-defibrillator (ICD) infection. We sought to define outcomes of lead extraction in patients with ESRD. METHODS ANDRESULTS:
Implantable cardioverter-defibrillator lead extractions at our institution from January 2006 to March 2014 were stratified by absence (Control-Ex, n = 465) or presence (ESRD-Ex, n = 43) of ESRD. Procedural outcomes and survival were determined by medical records review. Survival in the ESRD-Ex group was compared with a contemporaneous cohort with ESRD undergoing ICD lead implantation (ESRD-I, n = 127). Among extraction patients, those with ESRD were more likely to be extracted for infection (74.4% vs. 28.6%, P < 0.001). Extraction procedure success (Control-Ex 97% vs. ESRD-Ex 93%, P = 0.17) and procedural deaths (Control-Ex 1.1% vs. ESRD-Ex 2.3%, P = 0.413) were similar. Survival 1 year following extraction was worse in the ESRD-Ex group compared with the Control-Ex, with a survival rate of 65.6% vs. 92.6% (P < 0.001); these curves continued to diverge through year 3. One-year survival in the ESRD-Ex group was worse than among ESRD patients undergoing ICD implant (ESRD-I), but these curves converged and survival was similar by year 3.CONCLUSIONS:
Implantable cardioverter-defibrillator lead extraction can be performed safely and effectively in patients with ESRD. However, despite high rates of procedural success, long-term mortality following extraction in ESRD patients is substantial. Much of the long-term mortality risk appears to be accounted for by the presence of ESRD and an indication for an ICD.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Falha de Prótese
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Cardioversão Elétrica
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Infecções Relacionadas à Prótese
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Desfibriladores Implantáveis
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Remoção de Dispositivo
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Falência Renal Crônica
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article