Transvenous Lead Extraction in Pediatric Patients　― Is It the Same Procedure in Children as in Adults? ―

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  • Kutarski Andrzej
    Department of Cardiology, Medical University Lublin
  • Miszczak-Knecht Maria
    Department of Cardiology, The Children’s Memorial Health Institute
  • Brzezinska Monika
    Department of Cardiology, The Children’s Memorial Health Institute
  • Birbach Mariusz
    Department of Cardiac Surgery, The Children’s Memorial Health Institute
  • Lipiński Wojciech
    Department of Cardiac Surgery, The Children’s Memorial Health Institute
  • Polewczyk Aneta Maria
    Children’s Department of District Hospital
  • Jacheć Wojciech
    Second Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice
  • Polewczyk Anna
    Department of Physiology, Patophysiology and Clinical Immunology, Jan Kochanowski University, Institute of Medical Sciences Department of Cardiac Surgery, Świętokrzyskie Cardiology Center
  • Tułecki Łukasz
    Department of Cardiac Surgery, The Pope John Paul II Province Hospital
  • Tomków Konrad
    Department of Cardiac Surgery, The Pope John Paul II Province Hospital
  • Stefańczyk Paweł
    Department of Cardiology, The Pope John Paul II Province Hospital
  • Nowosielecka Dorota
    Department of Cardiology, The Pope John Paul II Province Hospital
  • Bieganowska Katarzyna
    Department of Cardiology, The Children’s Memorial Health Institute

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<p>Background: Cardiac implantable electronic devices (CIED) are very rare in the pediatric population. In children with CIED, transvenous lead extraction (TLE) is often necessary. The course and effects of TLE in children are different than in adults. Thus, this study determined the differences and specific characteristics of TLE in children vs. adults.</p><p>Methods and Results: A post hoc analysis of TLE data in 63 children (age ≤18 years) and 2,659 adults (age ≥40 years) was performed. The 2 groups were compared with respect to risk factors, procedure complexity, and effectiveness. In children, the predominant pacing mode was a single chamber ventricular system and lead dysfunction was the main indication for lead extraction. The mean implant duration before TLE was longer in children (P=0.03), but the dwell time of the oldest extracted lead did not differ significantly between adults and children. The duration (P=0.006) and mean extraction time per lead (P<0.001) were longer in children, with more technical difficulties during TLE in the pediatric group (P<0.001). Major complications were more common, albeit not significantly, in children. Complete radiographic and procedural success were significantly lower in children (P<0.001).</p><p>Conclusions: TLE in children is frequently more complex, time consuming, and arduous, and procedural success is more often lower. This is related to the formation of strong fibrous tissue surrounding the leads in pediatric patients.</p>

収録刊行物

  • Circulation Journal

    Circulation Journal 87 (7), 990-999, 2023-06-23

    一般社団法人 日本循環器学会

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