Academic Journal
Transvenous lead extraction: predictors of procedure complexity.
| Τίτλος: | Transvenous lead extraction: predictors of procedure complexity. |
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| Συγγραφείς: | Csillik A; Department of Cardiology, Buda Hospital of the Hospitaller Order of St John of God, Budapest, Hungary csillikandrea@gmail.com.; Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary., Gagyi R; Department of Internal Medicine, Cardiology Centre, University of Szeged, Szeged, Hungary., Szőllősi GJ; Faculty of Economics, University of Debrecen, Debrecen, Hungary., Kardos A; Gottsegen National Cardiovascular Center, Budapest, Hungary., Földesi C; Gottsegen National Cardiovascular Center, Budapest, Hungary., Som Z; Gottsegen National Cardiovascular Center, Budapest, Hungary., Vamos M; Department of Internal Medicine, Cardiology Centre, University of Szeged, Szeged, Hungary., Nemes A; Department of Internal Medicine, Cardiology Centre, University of Szeged, Szeged, Hungary., Saghy L; Department of Internal Medicine, Cardiology Centre, University of Szeged, Szeged, Hungary., Szili-Torok T; Department of Internal Medicine, Cardiology Centre, University of Szeged, Szeged, Hungary. |
| Πηγή: | Open heart [Open Heart] 2026 Apr 01; Vol. 13 (1). Date of Electronic Publication: 2026 Apr 01. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: BMJ Publishing Group Country of Publication: England NLM ID: 101631219 Publication Model: Electronic Cited Medium: Print ISSN: 2053-3624 (Print) Linking ISSN: 20533624 NLM ISO Abbreviation: Open Heart Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [London] : BMJ Publishing Group |
| Ιατρικοί όροι (MeSH): | Device Lead Extraction*/adverse effects , Device Lead Extraction*/methods , Pacemaker, Artificial*/adverse effects , Defibrillators, Implantable*/adverse effects , Prosthesis-Related Infections*/diagnosis , Prosthesis-Related Infections*/surgery , Device Removal*/adverse effects , Device Removal*/methods, Humans ; Retrospective Studies ; Female ; Risk Factors ; Male ; Treatment Outcome ; Time Factors ; Aged |
| Περίληψη: | Background and Aims: Over the past decades, high-volume lead extraction centres gained broad experience in advanced transvenous lead extractions (TLE). However, access to advanced TLE techniques is limited, thus it would be beneficial to predict which extractions can be performed safely and effectively by simple procedures. We aimed to report on predictors of procedure complexity in clinically successful TLEs. Methods: Our retrospective study included 70 infectious TLEs, of which 65 were clinically successful. TLEs were defined as simple if only simple manual traction or a locking stylet was required, and complex if a rotational mechanical sheath or a femoral snare was used. Results: 42 patients underwent a complex procedure and 23 patients underwent a simple procedure. Overall, 129 leads were extracted. Complex procedures were characterised by longer lead dwell time (mean: 10.7±6.5 years vs 3.2±2.1 years; p<0.01), and a greater rate of passive lead extraction (50% vs 17.4%; p=0.02). In multivariate logistic regression analysis, longer lead dwell time (OR=1.69; 95% CI 1.24 to 2.30; p=0.001) was an independent predictor of procedural complexity. Among active fixation leads, the cut-off lead age for complex extractions was 4.5 years. Conclusions: In the current single centre study, older lead age was the only independent predictor of procedural complexity. Based on this, the majority of infectious TLEs involving active fixation electrodes younger than 4.5 years may be safely performed even in centres where advanced TLE tools are unavailable. (© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.) |
| Competing Interests: | Competing interests: AK had consultancy/advisory/speaker contracts from Medtronic and Biotronik. CF received institutional grants from Medtronic, consulting fees from Medtronic and Biotronik Hungária Kft., payment or honoraria for lectures from Johnson and Johnson Co., Abbott Laboratories, Novartis Hungária Kft. and Boehringer Ingelheim RCV. MV reports educational activity and advisory relationship with Biotronik and educational activity on behalf of Boston Scientific/Twinmed, Medtronic, KRKA, Novo Nordisk and Pfizer, outside the submitted work. TS-T received institutional grants from Biotronik, Abbott NL, Biosense Webster, Acutus Medical, Stereotaxis, Catheter Precision and had consultancy/advisory/speakers contracts for product development with Biotronik, Ablacon, Acutus Medical and Stereotaxis. |
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| Contributed Indexing: | Keywords: Arrhythmias, Cardiac; Defibrillators, Implantable; Pacemaker, Artificial |
| Entry Date(s): | Date Created: 20260401 Date Completed: 20260714 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC13052646 |
| DOI: | 10.1136/openhrt-2026-003967 |
| PMID: | 41922091 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2053-3624 |
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| DOI: | 10.1136/openhrt-2026-003967 |