Abstract 17906: Increasing Complexity of Sprint Fidelis Lead Extraction: A Single Center Experience
Background: Sprint fidelis (SF) lead is associated with a time-dependent increase in fracture rate. SF is considered a “relatively easily” extractable lead with low complication rate. However, the simplicity in extraction may be related to the “younger” lead age, rather than the lead design. The time dependent increase in the complexity of its extraction has not been systematically evaluated.
Methods: We intended to perform a retrospective study evaluating the impact of the age of SF lead on the complexity of the procedure. Baseline characteristics, indication, procedural variables and complications of all consecutive patients who underwent SF lead extraction at a single tertiary care center were collected and analyzed. We divided the entire population into 2 groups based on the median age of the SF lead and compared the above variables between them. Mechanical traction with or without locking stylet was the initial method of extraction in all. Laser with or without mechanical devices were used when manual traction was insufficient to extract the lead.
Results: A total of 187 patients were included in the study. The mean age was 62 years with 73% males. The median age of the SF lead was 38 months. Group 1 (lead age 38months) had 93 and 94 patients respectively. There were no significant differences in the mean age, gender distribution, left ventricular ejection fraction, indications for extraction between both the groups. There was a significantly higher need to use laser in group 2 when compared to group 1 (56% vs 10%; p <0.001). There were no major complications in the study population. Minor complications occurred at the rate of 10% with no difference in both the groups.
Conclusion: There is a time dependent increase in complexity in extracting SF leads with no significant increase in complication rates. The risk of prophylactic extraction should be balanced with this increase in complexity associated with increasing age of the lead. P> Table: Comparison of patients in Group 1 (lead age <38months) and group 2 (lead age >38months).
- © 2012 by American Heart Association, Inc.