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

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.

The purpose of this study was to evaluate TLE outcomes of Ingevity leads.

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.

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).

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.