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 Viles Gonzalez

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background - 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. Methods and Results - 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. Conclusions - 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.

Original languageEnglish (US)
Pages (from-to)2363-2371
Number of pages9
JournalCirculation
Volume132
Issue number25
DOIs
StatePublished - 2015

Fingerprint

Blood Vessels
Pericardiocentesis
Hemorrhage
Equipment and Supplies
Cardiac Tamponade
Pericardial Effusion
International Classification of Diseases
Pneumothorax
Infection
Punctures
Respiratory Insufficiency
Hematoma
Thoracic Surgery
Lead
Inpatients
Stroke
Safety

Keywords

  • Complications
  • Device infection
  • Lead removal

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Deshmukh, A., Patel, N., Noseworthy, P. A., Patel, A. A., Patel, N., Arora, S., ... Viles Gonzalez, J. (2015). Trends in use and adverse outcomes associated with transvenous lead removal in the United States. Circulation, 132(25), 2363-2371. https://doi.org/10.1161/CIRCULATIONAHA.114.013801

Trends in use and adverse outcomes associated with transvenous lead removal in the United States. / Deshmukh, Abhishek; Patel, Nileshkumar; Noseworthy, Peter A.; Patel, Achint A.; Patel, Nilay; Arora, Shilpkumar; Kapa, Suraj; Noheria, Amit; Mulpuru, Siva; Badheka, Apurva; Fischer, Avi; Coffey, James O.; Cha, Yong Mei; Friedman, Paul; Asirvatham, Samuel; Viles Gonzalez, Juan.

In: Circulation, Vol. 132, No. 25, 2015, p. 2363-2371.

Research output: Contribution to journalArticle

Deshmukh, A, Patel, N, Noseworthy, PA, Patel, AA, Patel, N, Arora, S, Kapa, S, Noheria, A, Mulpuru, S, Badheka, A, Fischer, A, Coffey, JO, Cha, YM, Friedman, P, Asirvatham, S & Viles Gonzalez, J 2015, 'Trends in use and adverse outcomes associated with transvenous lead removal in the United States', Circulation, vol. 132, no. 25, pp. 2363-2371. https://doi.org/10.1161/CIRCULATIONAHA.114.013801
Deshmukh, Abhishek ; Patel, Nileshkumar ; Noseworthy, Peter A. ; Patel, Achint A. ; Patel, Nilay ; Arora, Shilpkumar ; Kapa, Suraj ; Noheria, Amit ; Mulpuru, Siva ; Badheka, Apurva ; Fischer, Avi ; Coffey, James O. ; Cha, Yong Mei ; Friedman, Paul ; Asirvatham, Samuel ; Viles Gonzalez, Juan. / Trends in use and adverse outcomes associated with transvenous lead removal in the United States. In: Circulation. 2015 ; Vol. 132, No. 25. pp. 2363-2371.
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AU - Patel, Nilay

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AU - Kapa, Suraj

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AU - Mulpuru, Siva

AU - Badheka, Apurva

AU - Fischer, Avi

AU - Coffey, James O.

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AU - Asirvatham, Samuel

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