The GermAn Laser Lead Extraction RegistrY: GALLERY

Europace. 2022 Oct 13;24(10):1627-1635. doi: 10.1093/europace/euac056.

Abstract

Aims: The GermAn Laser Lead Extraction RegistrY: GALLERY is a retrospective, national multicentre registry, investigating the safety and efficacy of laser lead extraction procedures in Germany.

Methods and results: Twenty-four 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. Safety and efficacy of laser lead extraction were investigated. A total number of 2524 consecutive patients with 6117 leads were included into the registry. 5499 leads with a median lead dwell time of 96 (62-141) months were treated. The mean number of treated leads per patient was 2.18 ± 1.02. The clinical procedural success rate was 97.86% and the complete lead removal was observed in 94.85%. Additional extraction tools were used in 6.65% of cases. The rate of procedural failure 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. Procedure-related mortality was 0.55%. Female sex and the presence of abandoned leads were predictors for procedure-related complications. The all-cause in-hospital mortality was 3.56% with systemic infection being the strongest predictor, followed by age ≥75 years and chronic kidney disease.

Conclusion: In the GALLERY, 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.

Keywords: CIED infection; Implantable cardioverter-defibrillator; Laser lead extraction; Lead endocarditis; Lead extraction; Pacemaker.

MeSH terms

  • Aged
  • Child
  • Defibrillators, Implantable* / adverse effects
  • Device Removal / methods
  • Female
  • Humans
  • Lasers, Excimer
  • Pacemaker, Artificial* / adverse effects
  • Postoperative Complications / etiology
  • Registries
  • Renal Insufficiency, Chronic*
  • Retrospective Studies
  • Treatment Outcome