A national, multicentre registry investigating the safety and efficacy of laser lead extraction has reported high success- and low procedure-related complication rates associated with the procedure. This is the headline finding of the GALLERY (German laser lead extraction gallery) retrospective registry, results from which have been published online in EP Europace.
Simon Pecha (University Heart and Vascular Center Hamburg, Hamburg, Germany) and colleagues report that 24 German centres that are performing laser lead extraction have participated in the registry.
All patients treated with a laser lead extraction procedure between January 2013 and March 2017, were consecutively enrolled in the study, which investigated the safety and efficacy of the laser lead extraction procedure.
A total of 2,524 consecutive patients with 6,117 leads were included in the registry, in which 5,499 leads with a median lead dwell time of 96 (62–141) months were treated. Investigators report that the mean number of treated leads per patient was 2.18±1.02.
Furthermore, Pecha et al note that the clinical procedural success rate was 97.86% and complete lead removal was observed in 94.85%. However, additional extraction tools were used in 6.65% of cases.
Meanwhile, the rate of procedural failure reported by the study team was 2.14% with lead age ≥10 years being its only predictor. The overall complication rate was 4.32%, including 2.06% major and 2.26% minor complications with procedure-related mortality reported as 0.55%. Female sex and the presence of abandoned leads were predictors for procedure-related complications, the investigators write in EP Europace. The all-cause in-hospital mortality rate was 3.56% with systemic infection being the strongest predictor, followed by age ≥75 years and chronic kidney disease.
In their concluding remarks, Pacha et al write: “In the GALLERY registry, a high success- and low procedure-related complication rates have been demonstrated. In multivariate analysis, female sex and the presence of abandoned leads were predictors for procedure-related complications, while the presence of systemic infection, age ≥75 years, and chronic kidney disease were independent predictors for all-cause mortality.”