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Related Experiment Video

Updated: Apr 3, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
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Transvenous lead extraction: predictors of procedure complexity.

Andrea Csillik1,2, Rita Gagyi3, Gergő József Szőllősi4

  • 1Department of Cardiology, Buda Hospital of the Hospitaller Order of St John of God, Budapest, Hungary csillikandrea@gmail.com.

Open Heart
|April 1, 2026
PubMed
Summary
This summary is machine-generated.

Older lead age predicts complexity in transvenous lead extractions (TLE). Most infectious TLEs with active fixation electrodes under 4.5 years can be performed safely without advanced tools.

Keywords:
Arrhythmias, CardiacDefibrillators, ImplantablePacemaker, Artificial

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Area of Science:

  • Cardiology
  • Medical Devices
  • Interventional Procedures

Background:

  • High-volume centers possess expertise in advanced transvenous lead extraction (TLE).
  • Predicting TLE complexity is crucial for centers with limited access to advanced techniques.
  • Identifying predictors of procedural complexity can guide safe and effective TLE performance.

Purpose of the Study:

  • To identify predictors of procedural complexity in clinically successful transvenous lead extractions (TLE).
  • To determine factors associated with simple versus complex TLE procedures.

Main Methods:

  • Retrospective analysis of 70 infectious transvenous lead extractions (TLEs).
  • Classification of TLEs as simple (manual traction/locking stylet) or complex (rotational sheath/femoral snare).
  • Multivariate logistic regression to identify independent predictors of procedural complexity.

Main Results:

  • Complex procedures were associated with longer lead dwell time (10.7 vs 3.2 years) and higher passive lead extraction rates (50% vs 17.4%).
  • Lead dwell time was an independent predictor of procedural complexity (OR=1.69).
  • For active fixation leads, a lead age of 4.5 years predicted complexity.

Conclusions:

  • Older lead age is the sole independent predictor of procedural complexity in infectious TLEs.
  • Infectious TLEs involving active fixation electrodes younger than 4.5 years can likely be performed safely without advanced TLE tools.