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RENEDI: Results of the first observational and prospective registry of transvenous lead extraction in Argentina. Inter-societary Working Group.
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  • Javier Ferrari Ayarragaray,
  • Ricardo Speranza,
  • Hector Mazzetti,
  • Alejandro Girela,
  • Claudio De Zuloaga,
  • Belen Nigro
Javier Ferrari Ayarragaray
Sanatorio de La Trinidad Mitre
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Ricardo Speranza
Hospital Nacional Profesor Alejandro Posadas
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Hector Mazzetti
Hospital General de Agudos Juan A Fernandez
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Alejandro Girela
Instituto Cardiovascular del Sur
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Claudio De Zuloaga
Hospital Nacional Profesor Alejandro Posadas
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Belen Nigro
Argentinian College of Cardiovascular Surgeons
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Abstract

Background and aim: RENEDI (“Registro Nacional de Extracción de Dispositivos”) is the first registry on Transvenous Lead Extraction (TLE) designed in Argentina with the objective of providing data on lead extraction real-world practice. Methods: An online database platform was designed. Data referred to patients, leads and extraction procedures were compiled and reviewed by a Committee. Results: A total of 621 leads were extracted from 325 patients (average age of 59 years; 71% male). The targeted leads included 374 pacemaker leads (61%), 176 implantable cardioverter-defibrillator leads (28%) and 71 cardiac resynchronization therapy devices (11%). Two hundred and thirty-three (38%) atrial, 367 (59%) ventricular and 21 (3%) coronary sinus leads placement. The average lead dwell time was 105. 9 months. The commonest indication for removal was infection (68%-Local 71%). Cardiovascular surgeons were usually the primary operator (81%). The presence of cardiovascular stand-by was reported in 72% of cases. Percutaneous approach (98%) was predominant. A total of 158 (25%) leads with a median dwell time of 33.3 months were extracted using simple traction. Overall complication rate was 4%. Only one major complication and no deaths were informed. Minor complications occurred in 3.6% of procedures. Complete procedural success was 96.2%. Incomplete extraction was obtained in 23 leads. No permanent disabling complications or procedure-related deaths were reported. Conclusions: Current Argentinian practice has demonstrated that TLE is a safe and effective procedure associated with a low incidence of complications and high success rate when it is performed in well-trained hands.