496 LONG TERM PROGNOSIS FOLLOWING TRANSVENOUS LEAD EXTRACTION: INSIGHTS FROM A SINGLE CENTER REGISTRY


 
 
 The purpose of this analysis was to investigate the long-term prognosis following transvenous lead extraction (TLE).
 
 
 
 We retrospectively studied all consecutive CIED patients who underwent TLE between January 2014 and January 2016 followed in our institution. The primary outcome was the composite endpoint of time to death or repeated TLE stratified by the presence of infection; secondary outcomes included individual components.
 
 
 
 Of the 191 patients (85% male, median age 70 years) who underwent TLE, 96 (50%) had infection and 95 (50%) were extracted for a different reason. Complete procedural success was achieved in 189 patients (99%) with no major complications. During a follow-up of 6.5 (5.4–7.1) years, infectious indication was associated with a significantly lower event-free survival (67% vs 83%; adjusted hazard ratio [aHR] 1.97, 95% confidence interval [CI] 1.02–3.81, P=0.04). The difference was significant also considering the death component (30% vs 10%, log-rank P<0.01); while the rate of re-repeated TLE was similar (4% vs 7%, P=0.62). In the infectious group, the presence of vegetation (aHR 2.56; 95% CI 1.17–5.63, P=0.02) and positive blood coltures (aHR 2.64; 95% CI 1.04–6.70, P=0.04) were independently associated with the primary outcome.
 
 
 
 Our long-term data showed a higher combined death or repeated TLE endpoint for patients who underwent TLE with infectious compared to those with a different indication. In the subgroup of infectious patients, the presence of vegetation and positive blood coltures were associated with poor prognosis despite an uncomplicated extraction and appropriate therapy.
