Trends in Use and Adverse Outcomes Associated with Transvenous Lead Removal in the United States

Abhishek Deshmukh; Nileshkumar Patel; Peter A Noseworthy; Achint A Patel; Nilay Patel; Shilpkumar Arora; Suraj Kapa; Amit Noheria; Siva Mulpuru; Apurva Badheka; Avi Fischer; James O Coffey; Yong Mei Cha; Paul Friedman; Samuel Asirvatham; Juan F Viles-Gonzalez

doi:10.1161/CIRCULATIONAHA.114.013801

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Trends in Use and Adverse Outcomes Associated with Transvenous Lead Removal in the United States

Journal article

Open access

Trends in Use and Adverse Outcomes Associated with Transvenous Lead Removal in the United States

Abhishek Deshmukh, Nileshkumar Patel, Peter A Noseworthy, Achint A Patel, Nilay Patel, Shilpkumar Arora, Suraj Kapa, Amit Noheria, Siva Mulpuru, Apurva Badheka, …

Circulation (New York, N.Y.), Vol.132(25), pp.2363-2371

2015-12-22

DOI: https://doi.org/10.1161/CIRCULATIONAHA.114.013801

PMID: 26534954

Abstract

Adolescent

Adult

Aged

Aged, 80 and over

Databases, Factual - trends

Defibrillators, Implantable - adverse effects

Defibrillators, Implantable - trends

Device Removal - adverse effects

Device Removal - trends

Female

Humans

Length of Stay - trends

Male

Middle Aged

Postoperative Complications - diagnosis

Postoperative Complications - epidemiology

Risk Factors

Sex Factors

Treatment Outcome

United States - epidemiology

Young Adult

Transvenous lead removal (TLR) has made significant progress with respect to innovation, efficacy, and safety. However, limited data exist regarding trends in use and adverse outcomes outside the centers of considerable experience for TLR. The aim of our study was to examine use patterns, frequency of adverse events, and influence of hospital volume on complications. Using the Nationwide Inpatient Sample, we identified 91 890 TLR procedures. We investigated common complications including pericardial complications (hemopericardium, cardiac tamponade, or pericardiocentesis), pneumothorax, stroke, vascular complications (consisting of hemorrhage/hematoma, incidents requiring surgical repair, and accidental arterial puncture), and in-hospital deaths described with TLR, defining them by the validated International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code. We specifically assessed in-hospital death (2.2%), hemorrhage requiring transfusion (2.6%), vascular complications (2.0%), pericardial complications (1.4%), open heart surgery (0.2%), and postoperative respiratory failure (2.4%). Independent predictors of complications were female sex and device infections. Hospital volume was not independently associated with higher complications. There was a significant rise in overall complication rates over the study period. The overall complication rate in patients undergoing TLR was higher than previously reported. Female sex and device infections are associated with higher complications. Hospital volume was not associated with higher complication rates. The number of adverse events in the literature likely underestimates the actual number of complications associated with TLR.

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Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.94 Cardiac Arrhythmia; 1.94.899 Cardiac Resynchronization Therapy
Web Of Science research areas: Cardiac & Cardiovascular Systems; Peripheral Vascular Disease
ESI research areas: Clinical Medicine

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Title: Trends in Use and Adverse Outcomes Associated with Transvenous Lead Removal in the United States
Creators: Abhishek Deshmukh - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.). deshmukh.abhishek@mayo.edu
Nileshkumar Patel - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.)
Peter A Noseworthy - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.)
Achint A Patel - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.)
Nilay Patel - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.)
Shilpkumar Arora - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.)
Suraj Kapa - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.)
Amit Noheria - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.)
Siva Mulpuru - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.)
Apurva Badheka - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.)
Avi Fischer - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.)
James O Coffey - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.)
Yong Mei Cha - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.)
Paul Friedman - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.)
Samuel Asirvatham - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.)
Juan F Viles-Gonzalez - From Mayo Clinic, Rochester, MN (A.D., P.A.N., S.K., A.N., S.M., Y.M.C., P.F., S. Asirvatham); University of Miami Miller School of Medicine, Miami, FL (N.P., J.O.C., J.F.V.-G.); Icahn School of Medicine at Mount Sinai, New York, NY (A.A.P., S. Arora); Yale New Haven Medical Center, New Haven, CT (A.B.); St. Jude Medical, Sylmar, CA (A.F.); and Saint Peter's University Hospital/Rutgers University, New Brunswick, NJ (N.P.)
Publication Details: Circulation (New York, N.Y.), Vol.132(25), pp.2363-2371
Language: English
Resource Type: Journal article
PMID: 26534954
Record Identifier: 991031615449702976