Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2026
Circumstances and clinical significance of cardiac troponin T elevation following transvenous lead extraction.
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Kosior Jarosław, Nowosielecka Dorota, Jacheć Wojciech, Polewczyk Anna, Kutarski Andrzej W
Аннотация
INTRODUCTION: Little is known about cardiac troponin T (cTnT) release during transvenous lead extraction (TLE).
AIM: The aim of the study was to identify factors influencing the intensity of cTnT release during TLE and to investigate whether the increase in cTnT levels after TLE has any prognostic significance for medium-term survival.
MATERIAL AND METHODS: Retrospective analysis of a TLE database.
RESULTS: In 166 consecutive patients who underwent the TLE procedure, an elevated hs cTnT level > 0.014 µg/l was present in almost 100%. The increase in troponin level 8 h after TLE (DcTnT8) was 900% of average and 400% of the median initial concentration. The factors most strongly associated with cTnT release during TLE were the age of the oldest extracted leads and the number of points on the Complex Indicator of Difficulty (CID) score. Additional procedural factors included the occurrence of technical problems, the need for second-line tools, hypotension > 1 min appearance, and traction on cardiac structures visible on transoesophageal echocardiography.
CONCLUSIONS: Elevated cTnT levels are observed following nearly all TLE procedures; however, they do not impact the incidence of major complications, perioperative mortality, or long-term survival rates. Longer dwelling time of the extracted leads and the procedural complexity of TLE are the primary determinants of the magnitude of cardiac troponin release.
AIM: The aim of the study was to identify factors influencing the intensity of cTnT release during TLE and to investigate whether the increase in cTnT levels after TLE has any prognostic significance for medium-term survival.
MATERIAL AND METHODS: Retrospective analysis of a TLE database.
RESULTS: In 166 consecutive patients who underwent the TLE procedure, an elevated hs cTnT level > 0.014 µg/l was present in almost 100%. The increase in troponin level 8 h after TLE (DcTnT8) was 900% of average and 400% of the median initial concentration. The factors most strongly associated with cTnT release during TLE were the age of the oldest extracted leads and the number of points on the Complex Indicator of Difficulty (CID) score. Additional procedural factors included the occurrence of technical problems, the need for second-line tools, hypotension > 1 min appearance, and traction on cardiac structures visible on transoesophageal echocardiography.
CONCLUSIONS: Elevated cTnT levels are observed following nearly all TLE procedures; however, they do not impact the incidence of major complications, perioperative mortality, or long-term survival rates. Longer dwelling time of the extracted leads and the procedural complexity of TLE are the primary determinants of the magnitude of cardiac troponin release.