Status and Associated Factors of Retained Cardiac Implantable Electronic Device Leads After Heart Transplantation and Impact on Long-term Prognosis
10.3969/j.issn.1000-3614.2025.04.005
- VernacularTitle:心脏移植术后心血管植入型电子器械导线残留情况与影响因素及其对远期预后的影响
- Author:
Xiaoying HU
1
;
Zhongkai LIAO
;
Jie HUANG
;
Wei WANG
;
Yunhu SONG
;
Zhe ZHENG
;
Sheng LIU
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 心内科,北京 100037
- Publication Type:Journal Article
- Keywords:
heart transplantation;
cardiac implantable electronic device;
retained lead
- From:
Chinese Circulation Journal
2025;40(4):346-351
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To assess the situation of retained cardiac implantable electronic device(CIED)leads after cardiac transplantation,the associated factors,and their impact on long-term prognosis.Methods:A retrospective analysis was conducted on 1 096 patients who underwent cardiac transplantation at Fuwai Hospital of the Chinese Academy of Medical Sciences from January 1,2005 to January 1,2022.Among them,204 patients(18.6%)received CIED therapy before cardiac transplantation.Two physicians independently reviewed the pre-and post-transplant chest X-rays to determine the presence of retained CIED leads.Logistic multivariate regression analysis was used to assess factors associated with retained CIED leads,and Kaplan-Meier survival curves were plotted to analyze the impact of retained CIED leads on long-term prognosis.Results:Among the 204 patients who received CIED therapy before cardiac transplantation,the highest proportion were those treated with implantable cardioverter defibrillator(ICD)and cardiac resynchronization therapy-defibrillator(CRT-D),accounting for 47.5%(97/204)and 40.7%(83/204),respectively.The mean duration from CIED implantation to cardiac transplantation was(45.1±40.0)months,and 38 patients(18.6%)had retained CIED leads after cardiac transplantation.The results of the logistic multivariate regression analysis showed that the duration from CIED implantation to cardiac transplantation was the only factor associated with retained CIED leads after cardiac transplantation(OR=1.020,95%CI:1.011-1.030,P=0.000).Cumulative all-cause survival rates among patients without CIED implantation(n=892),those without retained CIED leads(n=166),and those with retained CIED leads(n=38)were 88.5%,93.3%and 84.2%,respectively.Kaplan-Meier survival curve analysis showed no significant difference in cumulative all-cause survival among the three groups(log-rank P=0.643).Conclusions:In patients who received CIED implantation before cardiac transplantation,18.6%had retained leads after surgery.The duration from CIED implantation to cardiac transplantation is the only factor associated with lead retained after cardiac transplantation,but retained leads does not affect the outcome post heart transplantation.
