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The European Lead Extraction ConTRolled (ELECTRa) study: a European Heart Rhythm Association (EHRA) Registry of Transvenous Lead Extraction Outcomes
Univ Hosp Pisa, Dept Cardiol, Via Paradisa 2, I-56124 Pisa, Italy..
Sahlgrens Univ Hosp, Dept Cardiothorac Surg, S-41345 Gothenburg, Sweden..
Heart Ctr Brandenburg Bernau, Dept Cardiol, Ladeburger Str 17m, D-16321 Bernau, Germany.;Med Sch Brandenburg, Ladeburger Str 17m, D-16321 Bernau, Germany..
CHU La Timone, La Timone Univ Hosp, Arrhythmias Unit, Dept Cardiol, 265 Rue St Pierre, F-13005 Marseille, France..
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2017 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 38, no 40, p. 2995-3005Article in journal (Refereed) Published
Abstract [en]

Aims The European Lead Extraction ConTRolled Registry (ELECTRa), is a prospective registry of consecutive transvenous lead extraction (TLE) procedures conducted by the European Heart Rhythm Association (EHRA) in order to identify the safety and efficacy of the current practice of TLE Methods and results European centres performing TLE, invited by the organizing committee on behalf of EHRA, prospectively recruited all consecutive patients undergoing TLE at their institution. The primary endpoint was TLE safety defined by pre-discharge major procedure-related complications including death. Secondary endpoints included clinical and radiological success and overall complication rates. Outcomes were compared between Low Volume (LoV) vs. High Volume (HiV) centers (LoV < 30 and HiV >= 30 procedures/year). A total of 3555 consecutive patients (pts) of whom 3510 underwent TLE at 73 centres in 19 European countries were enrolled between November 2012 and May 2014. The primary endpoint of in-hospital procedure-related major complication rate was 1.7% [95% CI 1.3-2.1%] (58/3510 pts) including a mortality of 0.5% [95% CI 0.3-0.8%] (17/3510 pts). Approximately two-thirds (37/58) of these complications occurred during the procedure and one-third (21/58) in the post-operative period. The most common procedure related complications were those requiring pericardiocentesis or chest tube and/or surgical repair (1.4% [95% CI 1.0-1.8%]). Complete clinical and radiological success rates were 96.7% [95% CI 96.1-97.3%] and 95.7% [95% CI 95.2-96.2%], respectively. The all cause in-hospital major complications and deaths were significantly lower in HiV centres vs. LoV centres (2.4% [95% CI 1.9-3.0%] vs. 4.1% [95% CI 2.7-6.0%], P = 0.0146; and 1.2% [95% CI 0.8-1.6%] vs. 2.5% [95% CI 1.5-4.1%] P = 0.0088), although those related to the procedure did not reach statistical significance. Radiological and clinical successes were more frequent in HiV vs. LoV centres. Conclusion The ELECTRa study is the largest prospective registry on TLE and confirmed the safety and efficacy of the current practice of TLE. Lead extraction was associated with a higher success rate with lower all cause complication and mortality rates in high volume compared with low volume centres.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS , 2017. Vol. 38, no 40, p. 2995-3005
Keywords [en]
Multicentre registry, Transvenous lead extraction
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-340751DOI: 10.1093/eurheartj/ehx080ISI: 000413436400007PubMedID: 28369414OAI: oai:DiVA.org:uu-340751DiVA, id: diva2:1182985
Available from: 2018-02-15 Created: 2018-02-15 Last updated: 2018-02-15Bibliographically approved

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Blomström-Lundqvist, Carina

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