Abstract 18460: A Comparison of Complexity of Extraction Between Sprint Fidelis and Other Right Ventricular Leads

Abstract

Introduction: There is no data comparing the relative difficulty of extraction between Sprint Fidelis and other right ventricular (RV) leads. Methods: We performed a retrospective analysis of all consecutive RV lead extractions in a single large referral center performed between 2005 and 2011. RV leads were grouped into Fidelis, non-Fidelis ICD and pacemaker leads. Indications, baseline characteristics, procedural variables and outcomes were compared between the different RV leads. Results: A total of 475 patients were included in the study of which Fidelis, non-Fidelis ICD and pacemaker lead was extracted in 198 (42%), 128 (27%) and 149 (31%) of the patients with a mean lead age of 47, 42 and 71months respectively (p=0.002). Mean age of the population was 64years with no difference across the groups. The indications for extraction were prophylaxis (32%), infection (25%) and malfunction (18%) with Fidelis lead much more likely to be extracted for prophylaxis and malfunction than for infection when compared to the other 2 groups (p<0.001). Extraction support (ES) was needed in 302 (64%) (laser in 57% and mechanical device only in 43%) of the leads. Many more leads needed ES in the Fidelis group (77%) when compared to either the non-Fidelis ICD (56%) or the pacemaker group (52%) (p<0.001). Analysis of leads >24months old revealed that for a given lead age, Fidelis lead was much more likely to require ES when compared to both non-Fidelis ICD lead and the pacemaker lead (p=0.001). Complications occurred in 16%, 15% and 6% of the patients with Fidelis, non-Fidelis ICD and pacemaker leads respectively (p = 0.003 between ICD and pacemaker patients). One major complication occurred each in Fidelis and pacemaker group patients. Conclusion: Extraction of Sprint Fidelis lead appears to be more difficult than other RV ICD or pacemaker leads with similar major complication rate.