touchCARDIO touchCARDIO
Devices
Read Time: < 1 min

42/A case control study comparing long term outcomes of devices implanted via femoral vs conventional superior access

Copy Link
Published Online: Sep 27th 2010 European Journal of Arrhythmia & Electrophysiology. 2020;6(Suppl. 1):abstr42
Authors: S Griffiths (Presenting Author) - Royal Brompton Hospital, London; J Behar - Royal Brompton Hospital, London; M Debney - Royal Brompton Hospital, London; C Monkhouse - Barts Heart Centre, London; M Lowe - Barts Heart Centre, London; E Cantor - Royal Brompton Hospital, London; V Boyalla - Royal Brompton Hospital, London; N Karim - Royal Brompton Hospital, London; J Till - Royal Brompton Hospital, London; V Markides - Royal Brompton Hospital, London; J Clague - Royal Brompton Hospital, London; T Wong - Royal Brompton Hospital, London
Quick Links:
Article
Article Information
Article:

Background: The conventional route to insert cardiac implantable electronic devices (CIED) is not always possible. Devices implanted via the femoral route (F-CIED) remain an alternative option despite the advent of leadless and subcutaneous devices. However, the long-term outcomes of F-CIED, in particular complex F-CIED (implantable cardioverter defibrillators (ICD) and cardiac resynchronisation therapy (CRT) devices)), are not known. Furthermore, the feasibility and safety of extracting chronic femoral leads has not been reported.

Methods: All patients with F-CIED implanted between 2002-2019 at two high volume tertiary centres were included in the study. A total of 31 F-CIED (10 complex – ICD and CRT – and 21 simple – single and dual chamber pacemakers) were compared 1:3 to 93 matched controls of conventional devices implanted via superior venous access (C-CIED). Complications requiring intervention were classified as early (<30 days) and late (>30 days) following implant.

Results: Early complications were similar between F-CIED and C-CIED (6% vs 5%; p=0.85) and between complex F-CIED and simple F-CIED sub-groups (10% vs 5%; p=0.58). Late complications at 7.5 ± 4.9 years follow-up were higher with F-CIED compared to C-CIED (29% vs 11.6%; p<0.01) and greater with the complex F-CIED subgroup compared to simple F-CIED and complex C-CIED (60% vs 14% vs 7%; p<0.01). Eight of 12 late complications with F-CIED were related to the generator site including six generator erosions, one generator migration and one lead erosion. Eight femoral generators and 14 chronic leads (mean duration in situ 8.1 ± 2.1 years) were extracted without complication.

Conclusion: The early complication rate of F-CIED is similar to devices implanted by the conventional approach but there is an increased risk of late complications, particularly with complex femoral devices. Extraction of chronic femoral leads by expert operators in experienced centres is feasible and safe.

Further Resources

Share this Article
Related Content In Devices
  • Copied to clipboard!
    accredited arrow-down-editablearrow-downarrow_leftarrow-right-bluearrow-right-dark-bluearrow-right-greenarrow-right-greyarrow-right-orangearrow-right-whitearrow-right-bluearrow-up-orangeavatarcalendarchevron-down consultant-pathologist-nurseconsultant-pathologistcrosscrossdownloademailexclaimationfeedbackfiltergraph-arrowinterviewslinkmdt_iconmenumore_dots nurse-consultantpadlock patient-advocate-pathologistpatient-consultantpatientperson pharmacist-nurseplay_buttonplay-colour-tmcplay-colourAsset 1podcastprinter scenerysearch share single-doctor social_facebooksocial_googleplussocial_instagramsocial_linkedin_altsocial_linkedin_altsocial_pinterestlogo-twitter-glyph-32social_youtubeshape-star (1)tick-bluetick-orangetick-red tick-whiteticktimetranscriptup-arrowwebinar Sponsored Department Location NEW TMM Corporate Services Icons-07NEW TMM Corporate Services Icons-08NEW TMM Corporate Services Icons-09NEW TMM Corporate Services Icons-10NEW TMM Corporate Services Icons-11NEW TMM Corporate Services Icons-12Salary £ TMM-Corp-Site-Icons-01TMM-Corp-Site-Icons-02TMM-Corp-Site-Icons-03TMM-Corp-Site-Icons-04TMM-Corp-Site-Icons-05TMM-Corp-Site-Icons-06TMM-Corp-Site-Icons-07TMM-Corp-Site-Icons-08TMM-Corp-Site-Icons-09TMM-Corp-Site-Icons-10TMM-Corp-Site-Icons-11TMM-Corp-Site-Icons-12TMM-Corp-Site-Icons-13TMM-Corp-Site-Icons-14TMM-Corp-Site-Icons-15TMM-Corp-Site-Icons-16TMM-Corp-Site-Icons-17TMM-Corp-Site-Icons-18TMM-Corp-Site-Icons-19TMM-Corp-Site-Icons-20TMM-Corp-Site-Icons-21TMM-Corp-Site-Icons-22TMM-Corp-Site-Icons-23TMM-Corp-Site-Icons-24TMM-Corp-Site-Icons-25TMM-Corp-Site-Icons-26TMM-Corp-Site-Icons-27TMM-Corp-Site-Icons-28TMM-Corp-Site-Icons-29TMM-Corp-Site-Icons-30TMM-Corp-Site-Icons-31TMM-Corp-Site-Icons-32TMM-Corp-Site-Icons-33TMM-Corp-Site-Icons-34TMM-Corp-Site-Icons-35TMM-Corp-Site-Icons-36TMM-Corp-Site-Icons-37TMM-Corp-Site-Icons-38TMM-Corp-Site-Icons-39TMM-Corp-Site-Icons-40TMM-Corp-Site-Icons-41TMM-Corp-Site-Icons-42TMM-Corp-Site-Icons-43TMM-Corp-Site-Icons-44TMM-Corp-Site-Icons-45TMM-Corp-Site-Icons-46TMM-Corp-Site-Icons-47TMM-Corp-Site-Icons-48TMM-Corp-Site-Icons-49TMM-Corp-Site-Icons-50TMM-Corp-Site-Icons-51TMM-Corp-Site-Icons-52TMM-Corp-Site-Icons-53TMM-Corp-Site-Icons-54TMM-Corp-Site-Icons-55TMM-Corp-Site-Icons-56TMM-Corp-Site-Icons-57TMM-Corp-Site-Icons-58TMM-Corp-Site-Icons-59TMM-Corp-Site-Icons-60TMM-Corp-Site-Icons-61TMM-Corp-Site-Icons-62TMM-Corp-Site-Icons-63TMM-Corp-Site-Icons-64TMM-Corp-Site-Icons-65TMM-Corp-Site-Icons-66TMM-Corp-Site-Icons-67TMM-Corp-Site-Icons-68TMM-Corp-Site-Icons-69TMM-Corp-Site-Icons-70TMM-Corp-Site-Icons-71TMM-Corp-Site-Icons-72