{
  "abstract": "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.",
  "authors": [
    {
      "affiliations": [
        "Department of Cardiology, Buda Hospital of the Hospitaller Order of St John of God, Budapest, Hungary",
        "Doctoral School of Clinical Medicine, University of Szeged, Szeged, Hungary"
      ],
      "name": "Andrea Csillik"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Cardiology Centre, University of Szeged, Szeged, Hungary"
      ],
      "name": "Rita Gagyi"
    },
    {
      "affiliations": [
        "Faculty of Economics, University of Debrecen, Debrecen, Hungary"
      ],
      "name": "Gergő József Szőllősi"
    },
    {
      "affiliations": [
        "Gottsegen National Cardiovascular Center, Budapest, Hungary"
      ],
      "name": "Attila Kardos"
    },
    {
      "affiliations": [
        "Gottsegen National Cardiovascular Center, Budapest, Hungary"
      ],
      "name": "Csaba Földesi"
    },
    {
      "affiliations": [
        "Gottsegen National Cardiovascular Center, Budapest, Hungary"
      ],
      "name": "Zoltán Som"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Cardiology Centre, University of Szeged, Szeged, Hungary"
      ],
      "name": "Mate Vamos"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Cardiology Centre, University of Szeged, Szeged, Hungary"
      ],
      "name": "Attila Nemes"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Cardiology Centre, University of Szeged, Szeged, Hungary"
      ],
      "name": "Laszlo Saghy"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Cardiology Centre, University of Szeged, Szeged, Hungary"
      ],
      "name": "Tamas Szili-Torok"
    }
  ],
  "title": "Transvenous lead extraction: predictors of procedure complexity",
  "uid": "ec9e388e-d688-5033-bd7b-d7a49ed9b0d3"
}