{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T04:02:32Z","timestamp":1776744152523,"version":"3.51.2"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T00:00:00Z","timestamp":1693958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"Background<\/jats:title>The prevalence of young patients with cardiac implantable electronic devices (CIED) is steadily increasing, accompanied by a rise in the occurrence of complications related to CIEDs. Consequently, transvenous lead extraction (TLE) has become a crucial treatment approach for such individuals.<\/jats:p><\/jats:sec>Objective<\/jats:title>The purpose of this study was to examine the characteristics and procedural outcomes of young patients who undergo TLE, with a specific focus on identifying independent risk factors associated with adverse events.<\/jats:p><\/jats:sec>Methods<\/jats:title>All patients in the GALLERY (GermAn Laser Lead Extraction RegistrY) were categorized into two groups based on their age at the time of enrollment: 45 years or younger, and over 45 years. A subgroup analysis was conducted specifically for the younger population. In this analysis, predictor variables for all-cause mortality, procedural complications, and procedural failure were evaluated using multivariable analyses.<\/jats:p><\/jats:sec>Results<\/jats:title>We identified 160 patients aged 45 years or younger with a mean age of 35.3\u2009\u00b1\u20097.6 years and 42.5% (n<\/jats:italic>\u2009=\u200968) female patients. Leading extraction indication was lead dysfunction in 51.3% of cases, followed by local infections in 20.6% and systemic infections in 16.9%. The most common device to be extracted were implantable cardioverter-defibrillators (ICD) with 52.5%. Mean number of leads per patient was 2.2\u2009\u00b1\u20091.0. Median age of the oldest indwelling lead was 91.5 [54.75\u2013137.5] months. Overall complication rate was 3.8% with 1.9% minor and 1.9% major complications. Complete procedural success was achieved in 90.6% of cases. Clinical procedural success rate was 98.1%. Procedure-related mortality was 0.0%. The all-cause in-hospital mortality rate was 2.5%, with septic shock identified as the primary cause of mortality. Multivariable analysis revealed CKD (OR: 19.0; 95% CI: 1.84\u2013194.9; p<\/jats:italic>\u2009=\u20090.018) and systemic infection (OR: 12.7; 95% CI: 1.14\u2013142.8; p<\/jats:italic>\u2009=\u20090.039) as independent predictor for all-cause mortality. Lead age\u2009\u2265\u200910 years (OR: 14.58, 95% CI: 1.36\u2013156.2; p<\/jats:italic>\u2009=\u20090.027) was identified as sole independent risk factor for procedural complication.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>TLE in young patients is safe and effective with a procedure-related mortality rate of 0.0%. CKD and systemic infection are predictors for all-cause mortality, whereas lead age\u2009\u2265\u200910 years was identified as independent risk factor for procedural complications in young patients undergoing TLE.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2023.1251055","type":"journal-article","created":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T16:57:11Z","timestamp":1694019431000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Procedural outcome & risk prediction in young patients undergoing transvenous lead extraction\u2014a GALLERY subgroup 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