Cardiac Device Lead Removal by Laser Safe for Octogenarians

Safe and effective for octogenarians; similar risks as for non-octogenarians

TUESDAY, Oct. 18 (HealthDay News) -- Laser assisted extraction of leads from implanted cardiac devices (pacemakers and defibrillators) is safe and effective in the octogenarian population, with risks similar to those in the non-octogenarian population, according to a study published online Oct. 17 in Circulation: Arrhythmia and Electrophysiology.

Yasser Rodriguez, M.D., M.B.A., from the Miller School of Medicine in Miami, and colleagues evaluated the clinical outcomes of cardiac device complications in the octogenarian population. A total of 506 patients undergoing laser-assisted lead extraction between 2004 and 2009 were categorized into two groups on the basis of age: octogenarians (118 patients; mean age, 85 years) and non-octogenarians (388 patients; mean age, 64.2 years).

The investigators found that 814 leads were removed from the patients in the non-octogenarian group (atrial, 295; ventricular, 442; coronary sinus, 77), and 253 leads were removed from the octogenarian group (atrial, 99; ventricular, 145; coronary sinus, 9). For both the groups, the primary reason for the lead extraction was infection. The mean duration of the lead implant was 59.6 months for octogenarians and 38.6 months for non-octogenarians. The proportion of minor, major, and total complications did not differ significantly between the groups (P = 0.65, 0.56, and 0.50, respectively).

"Laser lead extraction is a safe and effective treatment method in octogenarian patients with multiple comorbidities. Octogenarian patients experienced a procedural success rate and complication rate comparable to their younger counterparts," the authors write.

One of the study authors disclosed financial relationships with medical device companies, including Spectranetics, Sorin, Medtronic, and Sensormatic/TYCO.

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