Academic Journal

Increased risk of lead transection and procedural complexity during extraction of thin-diameter, single filar pacemaker leads.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: Increased risk of lead transection and procedural complexity during extraction of thin-diameter, single filar pacemaker leads.
Συγγραφείς: Sajja A; Section of Electrophysiology, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA., Mekary W; Section of Electrophysiology, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA., Huang J; Section of Electrophysiology, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA., Alkhoder A; Section of Electrophysiology, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA., Bhatia N; Section of Electrophysiology, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA., Merchant FM; Section of Electrophysiology, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA., El-Chami MF; Section of Electrophysiology, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA. Electronic address: melcham@emory.edu.
Πηγή: Heart rhythm [Heart Rhythm] 2026 Sep; Vol. 23 (9), pp. e2116-e2120. Date of Electronic Publication: 2026 Apr 23.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier Country of Publication: United States NLM ID: 101200317 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1556-3871 (Electronic) Linking ISSN: 15475271 NLM ISO Abbreviation: Heart Rhythm Subsets: MEDLINE
Imprint Name(s): Original Publication: New York, NY : Elsevier, c2004-
Ιατρικοί όροι (MeSH): Pacemaker, Artificial*/adverse effects , Device Lead Extraction*/methods , Device Removal*/methods , Device Removal*/adverse effects , Electrodes, Implanted*/adverse effects , Equipment Failure*, Humans ; Retrospective Studies ; Female ; Equipment Design ; Aged ; Male ; Risk Factors
Περίληψη: Background: The Ingevity pacing lead (Boston Scientific) uses a thin-diameter, single filar design that is characterized by a lower tensile strength. This might result in lead transection when exposed to traction during transvenous lead extraction (TLE) and subsequently higher odds of procedural complexity and requirement for femoral extraction.
Objective: The purpose of this study was to evaluate TLE outcomes of Ingevity leads.
Methods: We performed a retrospective analysis of 428 pacemaker lead extraction procedures performed from June 2022 to October 2025. Procedures were categorized by whether they involved extraction of ≥1 Ingevity lead. Lead transection was defined as any mechanical break that results in lead transection.
Results: The mean patient age was 68.4 ± 13.4 years. Of 428 procedures, 50 (12%) involved Ingevity leads. Lead transection occurred in 11 of 50 Ingevity procedures vs 26 of 378 non-Ingevity procedures (22% vs 7%; P < .001). Ingevity leads had a shorter dwell time as than did non-Ingevity pacing leads (3.6 years vs 5.9 years; P = .017). Bailout femoral extraction was required in 7 of 50 Ingevity leads as compared with 15 of 378 (14% vs 3.96%; P = .002). After controlling for lead dwell time and the number of leads targeted for extraction, multivariate analysis showed that Ingevity leads were 6 times more likely to break than non-Ingevity leads (odds ratio 6.34; 95% confidence interval 2.6-15.5; P < .001).
Conclusion: Ingevity leads were over 6 times more likely to break during extraction than non-Ingevity leads, despite a shorter dwell time. This translated into a more complex TLE procedure with higher requirement for bailout femoral extraction.
(Copyright © 2026 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
Competing Interests: Disclosures Dr El-Chami is a consultant for Medtronic and Boston Scientific. The rest of the authors have no conflicts of interest.
Contributed Indexing: Keywords: Femoral extraction; Lead extraction; Lead fracture; Lead transection; Pacing leads
Entry Date(s): Date Created: 20260423 Date Completed: 20260826 Latest Revision: 20260910
Update Code: 20260911
DOI: 10.1016/j.hrthm.2026.03.1879
PMID: 42024058
Βάση Δεδομένων: MEDLINE