Transvenous Lead Extraction in Pediatric Patients-Is It the Same Procedure in Children as in Adults?

Background: Cardiac implantable electronic devices (CIED) are very rare in the pediatric population. In children with CIED, trans -venous lead extraction (TLE) is often necessary. The course and effects of TLE in children are different than in adults. Thus, this study determined the differences and specific characteristics of TLE in children vs. adults.Methods and Results: A post hoc analysis of TLE data in 63 children (age & LE;18 years) and 2,659 adults (age & GE;40 years) was per-formed. The 2 groups were compared with respect to risk factors, procedure complexity, and effectiveness. In children, the pre-dominant pacing mode was a single chamber ventricular system and lead dysfunction was the main indication for lead extraction. The mean implant duration before TLE was longer in children (P=0.03), but the dwell time of the oldest extracted lead did not differ significantly between adults and children. The duration (P=0.006) and mean extraction time per lead (P<0.001) were longer in chil-dren, with more technical difficulties during TLE in the pediatric group (P<0.001). Major complications were more common, albeit not significantly, in children. Complete radiographic and procedural success were significantly lower in children (P<0.001).Conclusions: TLE in children is frequently more complex, time consuming, and arduous, and procedural success is more often lower. This is related to the formation of strong fibrous tissue surrounding the leads in pediatric patients.

Automated summary

This study compared the differences in trans-venous lead extraction (TLE) between children and adults with cardiac implantable electronic devices (CIED). The results showed that TLE in children had longer operation time, more technical difficulties, and lower success rate. This is due to the formation of strong fibrous tissue surrounding the leads in pediatric patients.