Abstract 12320: Women Fare Equally Well With Cardiac Implantable Electronic Device Extraction
Introduction: As compared to men, women traditionally have higher complication rates from cardiac endovascular procedures. Data are conflicting as to whether female gender is an independent risk factor for complication following lead and device extraction of cardiac implantable electronic devices (CIED). We sought to determine whether women have a higher incidence of complications from this procedure and whether the indication for CIED extraction impacts complication rate.
Methods: We retrospectively reviewed 241 cases of CIED extraction from 1995-2011 and compared total and major complication rates in men versus women. Complication rates were also stratified based on indication for extraction (CIED infection and lead malfunction). Major complications were defined as pericardial effusion requiring pericardiocentesis, pneumothorax, hemorrhage requiring transfusion, vascular trauma and death.
Results: In total, 172 men and 69 women underwent CIED extraction from 1995-2011. There was no significant difference in the overall complication rate in men versus women following CIED extraction (64 of 172 men vs. 19 of 69 women, p=0.2). The complication rate did not differ significantly between men and women whether undergoing extraction for CIED infection (49 of 128 men vs. 14 of 43 women, p=0.5) or lead malfunction (15 of 44 men vs. 5 of 26 women, p=0.2). The incidence of major complications also did not differ significantly between men and women (13 of 172 men vs. 7 of 69 women, p=0.5). Amongst women, complication rates were similar regardless of indication for extraction (14 of 43 women with CIED infections vs. 5 of 26 women with lead malfunction, p=0.2).
Conclusions: Complication rates following CIED extraction do not differ significantly between men and women based on this large, single-center experience. Female gender alone does not appear to predispose to an adverse outcome and should not deter physicians from referring women for CIED extraction when otherwise indicated or appropriate.
- © 2013 by American Heart Association, Inc.