Transvenous Lead Extraction in Patients with Congenital Heart Disease

Background: /Objectives: A significant subset of congenital heart disease patients (CHD) undergo transvenous pacemaker (PM)/implantable cardioverter defibrillator (ICD) lead extraction (TLE) in their lifetime. We aimed to report on the outcome and complexity of TLEs in CHD patients where powered mechanical sheath was used. Methods: This retrospective study included 175 consecutive TLEs performed in our centre. Thirteen TLEs in CHD patients and 162 in non-CHD patients were performed. Overall, 264 leads were extracted. Results: CHD patients were younger at first lead implant (21,2 ± 17 vs. 57,1 ± 18 years; p<0,01) and at lead extraction (33,38 ± 13 vs. 63,31 ± 16 years; p<0,01). Leads extracted from CHD patients were significantly older than leads extracted from non-CHD patients (median: 8,0 vs. 4,0 years; p<0,01). CHD patients and non-CHD patients did not differ in procedural (92% vs 87%; p=0,581) and clinical success rates (100% vs 91%; p=0,269). The two patient groups did not differ in their procedural complication rate (0% vs 11%; p=0,191). There was no difference in the used extraction techniques: rotational-mechanical sheaths were used in 61% of CHD extractions, and in 38% of non-CHD extractions; p= 0,11. Conclusion: TLEs using rotational-mechanical sheaths as advanced technique can be safely and effectively performed in CHD patients. The outcome and complexity of TLEs in CHD patients is comparable with non-CHD patients undergoing such procedure