Malfunction-related transvenous lead extraction in hemodialysis patients was associated with a 27.3% major complication rate and 18.2% 30-day mortality despite preserved procedural success.
Does procedural indication affect early outcomes and 30-day mortality in hemodialysis patients undergoing transvenous lead extraction?
Hemodialysis patients undergoing transvenous lead extraction for malfunction-related indications have a significantly higher risk of early complications and 30-day mortality, highlighting the need for careful peri-procedural planning.
Absolute Event Rate: 0% vs 0%
BackgroundHemodialysis (HD) status is a recognized risk factor for adverse outcomes following transvenous lead extraction (TLE).However, HD patients are frequently analyzed as a single high-risk group, and the influence of extraction indication on early outcomes within this population remains incompletely defined 412 ObjectiveTo evaluate early and 30-day outcomes after TLE in HD versus non-HD patients and to assess whether procedural indication (infection vs noninfectious/malfunction-related) is associated with differential early risk among HD patients. MethodsWe analyzed a prospectively maintained, single-center TLE registry spanning 2004-2025.Patients were stratified by HD status and primary extraction indication.Endpoints were defined according to the 2017 Heart Rhythm Society (HRS) expert consensus statement.1Primary outcomes included survival to discharge and 30-day all-cause mortality. ResultsAmong 1,256 patients, 86 were receiving HD.Infection-related TLE accounted for 575 cases (HD n=64; non-HD n=511), while noninfectious/malfunction-related TLE accounted for 681 cases (HD n=22; non-HD n=659).In infection-related extractions, HD patients experienced longer length of stay but similar procedural success, survival to discharge, and 30-day mortality.In contrast, HD patients undergoing malfunction-related TLE had higher major complication rates (27.3%, 95% CI: 10.7%-50.2%)and higher 30-day mortality (18.2%, 95% CI: 5.2%-J o u r n a l P r e -p r o o f TLE Outcomes in Hemodialysis by Indication 4 40.3%),despite preserved procedural success.. Interpretation is limited by the small number of HD patients in this subgroup. ConclusionIn this prospective registry, procedural indication was associated with differential early outcomes among HD patients undergoing TLE.Malfunction-related extraction was associated with higher observed early event rates in HD patients and may warrant additional peri-procedural consideration.
Shah et al. (Sun,) reported a other. Malfunction-related transvenous lead extraction in hemodialysis patients was associated with a 27.3% major complication rate and 18.2% 30-day mortality despite preserved procedural success.