Abstract 13641: Feasibility of Same-Day Discharge After Uncomplicated Transvenous Lead Extraction

Abstract

Introduction: Transvenous lead extraction (TLE), while mostly a safe procedure, has risk of serious periprocedural complications. As such, overnight hospitalization remains a routine practice. Same-day discharge (SDD) may be considered in uncomplicated TLE. Herein, we sought evaluate the safety of SDD. Methods: This is a retrospective analysis of 89 consecutive pts who underwent TLE in our center from January through December 2020. SDD patients were compared those with longer hospital stay (non-SDD) with respect to clinical and procedural characteristics. The safety endpoint was incidence of re-hospitalization/death at 30-days. Results: 51 patients had SDD after TLE and 38 had non-SDD (median length of stay, 2 days IQR 1-5). 38% were female, with a mean age of 67±14 years and BMI of 27.9±7.4 Kg/m 2 . The main indication for TLE was malfunction for SDD vs infection for non-SDD (figure). Clinical characteristics were comparable, with a trend for a higher rate of co-morbidities predisposing to infection for non-SDD (figure). As expected, SDD patients had fewer leads to extract (1.5±0.6 vs 2.1±1.1; p=0.003), albeit with a similar dwelling time (105±65 months vs 114±70 months), and shorter procedural times (90±47 min vs 125±87 min; p=0.01). Of note, laser was used as an adjunct extraction tool at a comparable rate (75% vs 76%). There was no significant difference in the safety endpoint (8% SDD vs 3% non-SDD; p=ns), with 1 post-procedural death (pulmonary embolism) in the non-SDD group, and 4 re-hospitalizations in the SDD group: 1 for evacuation of a pocket hematoma, 1 for drainage of a late symptomatic pericardial effusion secondary to pericarditis, 1 for lead revision. Conclusions: SDD discharge following uncomplicated TLE in selected patients is feasible, with an acceptable safety profile with respect to 30-days clinical outcomes.