Lead Break during Extraction: Predisposing Factors and Impact on Procedure Complexity and Outcome: Analysis of 3825 Procedures
Abstract
:1. Introduction
1.1. Goal of the Study
1.2. Novel Elements
2. Methods
2.1. Study Population
2.2. Lead Extraction Procedure
2.2.1. Procedure Complexity
2.2.2. Unexpected Technical Problems during TLE
2.2.3. Procedure Information
2.2.4. Definition of Lead Break during Extraction
2.2.5. Extraction of Distal Fragments of the Broken Lead
2.3. Dataset and Statistical Methods
2.3.1. Creation of Patient Subgroups for Analysis
2.3.2. Statistical Analysis
2.4. Approval of the Bioethics Committee
3. Results
4. Results Summary
5. Discussion
6. Conclusions
- Lead break during lead extraction occurs in 6.04% of cases, but broken lead fragments can be removed in 35.50% of patients, or the length of these fragments can be significantly reduced in 12.99% of patients.
- A larger sum of lead dwell times, a higher left ventricular ejection fraction, a higher number of previous CIED-related procedures, and the extraction of passive fixation leads were the strongest predictors of lead break during extraction. Some scores (LED index and LECOM score) predicted an increased risk of lead break.
- Lead break increases procedure difficulty and complexity, as well as the risk of TLE-related major complications. Thus, the possibility of lead break should be taken into account when planning the removal strategy and training in regards to transvenous lead extraction.
7. Study Limitations
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient-Related Predictors of TLE Complexity, Major Complications and Coexisting Indications for TLE | Lead Break with a Long Fragment | Lead Break with a Short Fragment | Lead Break of the Tip of the Lead Only | Lead Break with Loss of a Free-Floating Fragment | All Extractions with Lead Break | All Extractions without Lead Break |
---|---|---|---|---|---|---|
Mean ± SD N (%) M–W U test, Chi2 test | Mean ± SD N (%) M–W U test, Chi2 test | Mean ± SD N (%) M–W U test, Chi2 test | Mean ± SD N (%) M–W U test, Chi2 test | Mean ± SD N (%) M–W U test, Chi2 test | Mean ± SD N (%) | |
Group number/number of patients (%) | 1/95 (2.48) | 2/46 (1.20) | 3/68 (1.78) | 4/22 (0.57) | 5/231 (6.04) | 6/3594 (93.96) |
Patient age during TLE (years) | 59.29 ± 19.36 p < 0.001 | 56.67 ± 21.57 p = 0.001 | 60.40 ± 19.79 p = 0.022 | 66.09 ± 14.03 p = 0.724 | 59.75 ± 19.55 p < 0.001 | 66.44 ± 15.34 |
Patient age at first system implantation (years) | 43.65 ± 20.39 p < 0.001 | 41.93 ± 22.28 p < 0.001 | 47.74 ± 21.35 p < 0.001 | 50.14 ± 17.71 p = 0.015 | 45.14 ± 20.87 p < 0.001 | 58.14 ± 15.34 |
Female | 48 (50.53) p = 0.016 | 17 (36.96) p = 0.970 | 25 (36.76) p = 0.964 | 6 (27.27) p = 0.427 | 96 (41.56) p = 0.282 | 1358 (37.79) |
Ischemic heart disease | 31 (32.63) p < 0.001 | 18 (39.13) p < 0.001 | 37 (54.41) p = 785 | 11 (50.00) p = 0.669 | 97 (41.99) p < 0.001 | 2042 (56.82) |
NYHA FC III or IV | 12 (12.63) p = 0.491 | 4 (8.70) p = 0.268 | 11 (16.18) p = 0.938 | 4 (18.18) p < 0.830 | 34 (14.72) p = 0.738 | 567 (15.78) |
LVEF (%) | 55.14 ± 11.98 p < 0.001 | 55.41 ± 10.58 p = 0.003 | 54.04 ± 12.53 p = 0.015 | 52.59 ± 13.49 p = 0.266 | 54.63 ± 11.98 p < 0.001 | 49.14 ± 15.44 |
Charlson co-morbidity index (points) | 4.12 ± 4.14 p < 0.001 | 3.04 ± 3.11 p < 0.001 | 3.53 ± 3.15 p = 0.003 | 3.96 ± 3.15 p = 0.421 | 3.71 ± 3.59 p < 0.001 | 4.81 ± 3.69 |
Indications for TLE | ||||||
Infective endocarditis, with or without pocket infection | 14 (14.74) p = 0.125 | 12 (26.09) p = 0.608 | 14 (20.59) p = 0.978 | 7 (31.82) p = 0.385 | 47 (20.35) p = 0.651 | 785 (21.84) |
Local (isolated) pocket infection | 11 (11.58) p = 0.958 | 3 (6.52) p = 0.676 | 10 (14.71) p = 0.208 | 2 (9.09) p = 0.868 | 26 (11.26) p = 0.425 | 339 (9.43) |
Mechanical lead damage (electrical failure) | 42 (44.21) p < 0.001 | 18 (39.13) p = 0.076 | 20 (29.41) p = 0.676 | 4 (18.18) p = 0.529 | 84 (36.36) p = 0.001 | 949 (26.41) |
Lead dysfunction (exit/entry block, dislodgement, perforation, extracardiac pacing) | 11 (11.58) p = 0.013 | 8 (17.39) p = 0.474 | 13 (19.12) p = 0.548 | 3 (13.64) p = 0.434 | 35 (15.15) p = 0.008 | 825 (22.96) |
Change of pacing mode/upgrading, downgrading | 5 (5.26) p = 0.751 | 0 (0.00) p = 0.132 | 2 (2.94) p = 0.334 | 0 (0.00) p = 0.414 | 7 (3.03) p = 0.043 | 238 (6.62) |
Other non-infectious indications * | 12 (12.63) p = 0.902 | 5 (10.87) p = 0.876 | 9 (13.24) p = 0.950 | 6 (27.27) p = 0.087 | 32 (13.85) p = 0.698 | 458 (12.74) |
System-Related Risk Factors for TLE Complexity and Major Complications | Lead Break with a Long Fragment | Lead Break with a Short Fragment | Lead Break of the Tip of the Lead Only | Lead Break with Loss of a Free-Floating Fragment | All Extractions, with Lead Break | All Extractions, without Lead Break |
---|---|---|---|---|---|---|
Mean ± SD N (%) M–W U test, Chi2 test | Mean ± SD N (%) M–W U test, Chi2 test | Mean ± SD N (%) M–W U test, Chi2 test | Mean ± SD N (%) M–W U test, Chi2 test | Mean ± SD N (%) M–W U test, Chi2 test | Mean ± SD N (%) | |
Group number/number of patients (%) | 1/95 (2.48) | 2/46 (1.20) | 3/68 (1.78) | 4/22 (0.57) | 5/231 (6.04) | 6/3594 (93.96) |
System and history of pacing | ||||||
Oldest lead before TLE (months) | 188.8 ± 86.14 p < 0.001 | 177.7 ± 85.46 p < 0.001 | 151.7 ± 90.68 p < 0.001 | 191.7 ± 106.0 p < 0.001 | 176.0 ± 90.26 p < 0.001 | 97.66 ± 72.71 |
Global lead dwell time (years) before TLE | 29.86 ± 17.69 p < 0.001 | 28.36 ± 13.37 p < 0.001 | 22.76 ± 13.00 p < 0.001 | 35.51 ± 21.89 p < 0.001 | 28.01 ± 16.46 p < 0.001 | 14.62 ± 12.28 |
Abandoned leads before TLE | 27 (28.42) p < 0.001 | 10 (21.74) p = 0.008 | 14 (20.59) p = 0.004 | 12 (54.55) p < 0.001 | 63 (27.27) p < 0.001 | 354 (9.85) |
Unnecessary (large) lead loop in the heart | 10 (10.53) p = 0.005 | 6 (13.04) p = 0.005 | 3 (4.41) p = 1.000 | 7 (31.82) p < 0.001 | 26 (11.26) p < 0.001 | 158 (4.40) |
Number of leads in the heart before TLE | 2.16 ± 0.84 p = 0.004 | 2.20 ± 0.62 p = 0.005 | 2.10 ± 0.79 p = 0.071 | 2.68 ± 1.21 p = 0.027 | 2.20 ± 0.84 p < 0.001 | 1.94 ± 0.73 |
≥4 leads in the heart before TLE | 8 (8.42) p < 0.001 | 0 (0.00) p = 0.260 | 5 (7.35) p < 0.001 | 7 (31.82) p < 0.001 | 20 (8.66) p < 0.001 | 98 (2.73) |
Leads on both sides of the chest before TLE | 7 (7.37) p = 0.003 | 0 (0.00) p = 0.280 | 6 (8.82) p < 0.001 | 5 (22.73) p < 0.001 | 18 (7.79) p < 0.001 | 89 (2.48) |
Number of procedures before lead extraction | 2.90 ± 1.67 p < 0.001 | 2.54 ± 1.24 p < 0.001 | 2.45 ± 1.41 p < 0.001 | 2.76 ± 1.14 p < 0.001 | 2.68 ± 1.47 p < 0.001 | 1.81 ± 1.03 |
Two or more CIED procedures before TLE | 84 (83.42) p < 0.001 | 37 (80.43) p < 0.001 | 51 (75.00) p = 0.001 | 19 (86.36) p = 0.001 | 191 (82.68) p = 0.001 | 1834 (51.03) |
Risk scores for prediction of major complications or increased procedure complexity. | ||||||
SAFeTY-TLE score (points) | 10.75 ± 4.55 p < 0.001 | 9.62 ± 4.11 p < 0.001 | 6.36 ± 3.82 p < 0.001 | 10.07 ± 5.03 p < 0.001 | 9.75 ± 4.59 p < 0.001 | 5.67 ± 4.07 |
SAFeTY-TLE score (%) | 5.80 ± 8.89 p < 0.001 | 3.69 ± 3.00 p < 0.001 | 3.36 ± 4.75 p < 0.001 | 3.89 ± 3.31 p < 0.001 | 4.48 ± 6.64 p < 0.001 | 1.54 ± 2.43 |
EROS score (points) | 2.15 ± 0.92 p < 0.001 | 2.11 ± 0.82 p < 0.001 | 1.81 ± 0.87 p < 0.014 | 2.27 ± 0.83 p < 0.001 | 2.05 ± 0.89 p < 0.001 | 1.50 ± 0.71 |
MB score (points) | 3.53 ± 0.68 p < 0.001 | 3.50 ± 0.78 p < 0.001 | 3.32 ± 0.89 p < 0.001 | 3.46 ± 0.91 p < 0.001 | 3.46 ± 0.79 p < 0.001 | 2.53 ± 1.25 |
LED index (points) | 17.37 ± 7.11 p < 0.001 | 16.46 ± 7.08 p < 0.001 | 13.52 ± 7.46 p < 0.001 | 18.32 ± 9.04 p < 0.001 | 16.44 ± 7.48 p < 0.001 | 9.65 ± 6.10 |
Advanced TLE (Mazzone) scale (points) | 2.53 ± 0.70 p < 0.001 | 2.50 ± 0.69 p = 0.006 | 2.49 ± 0.70 p = 0.001 | 2.41 ± 0.80 p = 0.154 | 2.50 ± 0.70 p < 0.001 | 2.12 ± 0.93 |
LECOM score (points) | 12.97 ± 4.20 p < 0.001 | 12.45 ± 3.50 p < 0.001 | 11.20 ± 4.07 p < 0.001 | 14.18 ± 5.32 p < 0.001 | 12.36 ± 4.23 p < 0.001 | 7.94 ± 3.96 |
LECOM score (%) | 41.81 ± 22.15 p < 0.001 | 39.76 ± 20.58 p < 0.001 | 33.07 ± 21.00 p < 0.001 | 50.34 ± 29.69 p < 0.001 | 39.64 ± 22.76 p < 0.001 | 19.08 ± 17.43 |
LECOM score (patients with very high expected complexity of the procedure) | 79 (83.16) p < 0.001 | 33 (71.54) p < 0.001 | 45 (66.18) p < 0.001 | 18 (81.83) p < 0.001 | 175 (76.76) p < 0.001 | 1135 (31.58) |
Potential procedure-related risk factors for major complications and increased procedure complexity. | ||||||
Number of extracted leads per patient | 2.01 ± 0.88 p < 0.001 | 1.96 ± 0.70 p < 0.001 | 1.87 ± 0.69 p = 0.002 | 2.50 ± 1.10 p < 0.004 | 2.00 ± 0.82 p < 0.001 | 1.63 ± 0.72 |
Extraction of abandoned lead(s) (any) | 26 (27.37) p < 0.001 | 10 (21.74) p = 0.003 | 13 (19.12) p = 0.004 | 11 (50.00) p < 0.001 | 60 (25.97) p < 0.001 | 322 (8.96) |
Extraction of old model UP leads (excluding LV leads) | 29 (30.53) p < 0.001 | 9 (19.57) p < 0.001 | 10 (14.71) p = 0.002 | 8 (36.36) p < 0.001 | 56 (24.24) p < 0.001 | 210 (5.84) |
Extraction of passive fixation leads (excluding LV leads) | 88 (92.63) p < 0.001 | 45 (97.83) p < 0.001 | 62 (91.18) p < 0.001 | 20 (90.91) p = 0.001 | 215 (93.07) p < 0.001 | 2008 (55.87) |
Extraction of VDD leads | 7 (7.37) p = 0.005 | 1 (2.17) p = 0.860 | 1 (1.47) p = 0.564 | 1 (4.55) p = 0.565 | 10 (4.33) p = 0.113 | 93 (2.59) |
Extraction of leads with redundant loop in the heart | 11 (11.58) p = 0.002 | 6 (13.04) p = 0.007 | 2 (2.94) p = 0.518 | 8 (36.36) p < 0.001 | 32 (13.85) p < 0.001 | 165 (4.59) |
Oldest lead extracted per patient (months) | 185.3 ± 83.85 p < 0.001 | 176.7 ± 85.69 p < 0.001 | 152.0 ± 90.68 p < 0.001 | 191.7 ± 106.04 p < 0.001 | 174.3 ± 89.25 p < 0.001 | 95.90 ± 71.68 |
Sum of dwell times of extracted leads (years) | 28.46 ± 17.41 p < 0.001 | 26.13 ± 14.48 p < 0.001 | 21.29 ± 13.15 p < 0.001 | 35.51 ± 21.89 p < 0.001 | 26.56 ± 16.62 p < 0.001 | 12.96 ± 11.95 |
Procedure Complexity | Lead Break with a Long Fragment | Lead Break with a Short Fragment | Lead Break of the Tip of the Lead Only | Lead Break with Loss of a Free-Floating Fragment | All Extractions, with Lead Break | All Extractions, without Lead Break |
---|---|---|---|---|---|---|
Mean ± SD N (%) M–W U test, Chi2 test | Mean ± SD N (%) M–W U test, Chi2 test | Mean ± SD N (%) M–W U test, Chi2 test | Mean ± SD N (%) M–W U test, Chi2 test | Mean ± SD N (%) M–W U test, Chi2 test | Mean ± SD N (%) | |
Group number/number of patients (%) | 1/95 (2.48) | 2/46 (1.20) | 3/68 (1.78) | 4/22 (0.57) | 5/231 (6.04) | 6/3594 (93.96) |
TLE complexity and outcomes | ||||||
Extraction time (sheath-to-sheath) (minutes) | 69.80 ± 49.46 p < 0.001 | 27.20 ± 14.47 p < 0.001 | 24.74 ± 28.10 p < 0.001 | 92.73 ± 77.15 p < 0.001 | 50.23 ± 49.44 p < 0.001 | 12.77 ± 18.01 |
* Average time of single lead extraction (minutes) | 38.75 ± 31.64 p < 0.001 | 15.70 ± 9.51 p < 0.001 | 12.83 ± 12.76 p < 0.001 | 44.09 ± 50.76 p < 0.001 | 27.04 ± 29.65 p < 0.001 | 7.75 ± 9.55 |
Overall number of technical problems in the group of patients | 95 (100.0) p < 0.001 | 32 (69.57) p < 0.001 | 26 (38.24) p < 0.001 | 22 (100.0) p < 0.001 | 175 (75.76) p < 0.001 | 552 (15.36) |
Number of technical problems per patient | 2.21 ± 1.02 p < 0.001 | 1.53 ± 0.62 p < 0.001 | 1.54 ± 0.71 p < 0.001 | 2.73 ± 1.03 p < 0.001 | 2.05 ± 0.99 p < 0.001 | 1.24 ± 0.50 |
Two or more technical problems | 69 (72.63) p = 0.001 | 15 (32.61) p = 0.001 | 12 (17.65) p = 0.001 | 22 (100.0) p = 0.001 | 118 (51.08) p = 0.001 | 115 (3.20) |
Utilitization of additional tools and techniques | ||||||
Evolution (old and new) or TightRail | 15 (15.79) p < 0.001 | 4 (8.70) p < 0.001 | 6 (8.82) p < 0.001 | 4 (18.18) p < 0.001 | 29 (12.55) p < 0.001 | 29 (0.81) |
Metal sheaths | 29 (30.53) p < 0.001 | 9 (19.57) p < 0.001 | 12 (17.65) p = 0.001 | 5 (22.73) p = 0.006 | 55 (23.81) p < 0.001 | 261 (7.26) |
Lasso catheters/snares, basket catheters | 91 (95.79) p < 0.001 | 12 (26.09) p < 0.001 | 4 (5.88) p = 0.014 | 22 (100.0) p < 0.001 | 129 (55.84) p < 0.001 | 65 (1.81) |
Need to use an alternative approach | 36 (37.89) p < 0.001 | 2 (4.35) p = 0.281 | 5 (7.35) p = 0.003 | 10 (45.45) p < 0.001 | 53 (22.94) p < 0.001 | 74 (2.06) |
Procedure difficulty score | ||||||
** Retrospective TLE combined difficulty score (points) | 3.58 ± 0.79 p < 0.001 | 1.98 ± 1.34 p < 0.001 | 1.04 ± 1.43 p < 0.001 | 3.82 ± 0.73 p < 0.001 | 2.54 ± 1.61 p < 0.001 | 0.43 ± 0.95 |
Retrospective TLE combined difficulty score of two or more points | 95 (100.0) p < 0.001 | 33 (71.74) p < 0.001 | 23 (33.82) p < 0.001 | 22 (100.0) p < 0.001 | 173 (74.89) p < 0.001 | 556 (15.47) |
Procedure Complications and Long-Term Outcomes | Lead Break with a Long Fragment | Lead Break with a Short Fragment | Lead Break of the Tip of the Lead Only | Lead Break with Loss of a Free-Floating Fragment | All Extractions, with Lead Break | All Extractions, without Lead Break |
---|---|---|---|---|---|---|
N (%) Chi2 test | N (%) Chi2 test | N (%) Chi2 test | N (%) Chi2 test | N (%) Chi2 test | N (%) | |
Group number/number of patients (%) | 1/95 (2.48) | 2/46 (1.20) | 3/68 (1.78) | 4/22 (0.57) | 5/231 (6.04) | 6/3594 (93.96) |
TLE efficacy and complications | ||||||
Major complications (any) | 7 (7.37) p < 0.001 | 7 (15.22) p < 0.001 | 5 (7.35) p < 0.001 | 4 (18.18) p < 0.001 | 23 (9.96) p < 0.001 | 55 (1.53) |
Hemopericardium | 4 (4.21) p = 0.002 | 5 (10.87) p < 0.001 | 3 (4.41) p = 0.004 | 1 (4.55) p = 0.080 | 13 (5.63) p < 0.001 | 33 (0.92) |
Hemothorax | 1 (1.05) p = 0.014 | 0 (0.00) p = 0.821 | 0 (0.00) p = 0.783 | 0 (0.00) p = 0.877 | 1 (0.43) p = 0.190 | 4 (0.11) |
Tricuspid valve damage during TLE (severe) | 2 (2.11) p = 0.017 | 1 (2.17) p = 0.074 | 2 (2.94) p = 0.002 | 3 (13.64) p < 0.001 | 8 (3.46) p < 0.001 | 15 (0.42) |
Rescue cardiac surgery | 4 (4.21) p = 0.001 | 4 (8.70) p < 0.001 | 2 (2.94) p = 0.057 | 1 (4.55) p = 0.054 | 11 (4.76) p < 0.001 | 29 (0.81) |
Death, procedure-related (intra-,post-procedural) | 0 (0.00) p = 0.691 | 0 (0.00) p = 0.783 | 0 (0.00) p = 0.736 | 0 (0.00) p = 0.847 | 0 (0.00) p = 0.534 | 6 (0.17) |
Clinical success | 84 (88.42) p < 0.001 | 34 (73.91) p < 0.001 | 43 (63.24) p < 0.001 | 19 (86.36) p < 0.001 | 180 (77.92) p < 0.001 | 3567 (99.25) |
Complete procedural success | 58 (61.05) p < 0.001 | 6 (13.04) p < 0.001 | 1 (1.47) p < 0.001 | 12 (54.55) p < 0.001 | 77 (33.33) p < 0.001 | 3565 (99.19) |
Long-term mortality after TLE | ||||||
Survivors | 64 (67.37) p = 0.549 | 33 (71.74) p = 0.300 | 49 (72.06) p = 0.190 | 11 (50.00) p = 0.160 | 157 (67.97) p = 0.270 | 2314 (64.39) |
One-year mortality | 12 (12.63) p = 0.115 | 4 (8.70) p = 0.890 | 2 (2.94) p = 0.119 | 3 (13.64) p = 0.347 | 21 (9.09) p = 0.604 | 292 (8.13) |
Overall follow-up mortality | 31 (32.63) p = 0.549 | 13 (28.26) p = 0.300 | 19 (27.94) p = 0.190 | 11 (50.00) p = 0.160 | 74 (32.036) p = 0.270 | 1280 (35.62) |
Management of Lead Break | Lead Break with a Long Fragment | Lead Break with a Short Fragment | Lead Break of the Tip of the Lead Only | Lead Break with Loss of Broken Lead Fragment or Lead Tip | All Extractions, with Lead Break |
---|---|---|---|---|---|
N (%) | N (%) | N (%) | N (%) | N (%) | |
Group number/number of patients (%) | 1/95 (2.48) | 2/46 (1.20) | 3/68 (1.78) | 4/22 (0.57) | 5/231 (6.04) |
Grasped remnant entirely removed | 63 (66.32) | 4 (8.70) | 0 (0.00) | 15 (68.18) | 82 (35.50) |
Shortening the lead remnant, with a retained fragment < 4 cm | 26 (27.37) | 1 (2.17) | 0 (0.00) | 3 (13.64) | 30 (12.99) |
Unsuccessful attempt at retrieval of the fragment | 3 (3.16) | 10 (21.74) | 0 (0.00) | 4 (18.18) | 17 (7.36) |
No attempt made to grasp the fragment (no chance) | 0 (0.00) | 29 (63.04) | 68 (100.0) | 0 (0.00) | 97 (41.99) |
Lead remnant removal during emergency or planned cardiac surgery | 3 (3.16) | 1 (2.17) | 0 (0.00) | 0 (0.00) | 4 (1.73) |
Procedure aborted due to major complications and ultimately, death of the patient | 0 (0.00) | 1 (2.17) | 0 (0.00) | 0 (0.00) | 1 (0.43) |
Univariable Regression Model | Multivariable Regression Model | |||||
---|---|---|---|---|---|---|
OR | 95% CI | p | OR | 95% CI | p | |
Patient age during TLE (by 1 year) | 0.977 | 0.970–0.984 | <0.001 | |||
Patient age at first system implantation (by 1 year) | 0.965 | 0.959–0.971 | <0.001 | 0.971 | 0.961–0.981 | <0.001 |
Sum of all lead dwell times (by 1 year) | 1.126 | 1.107–1.145 | <0.001 | 1.018 | 1.005–1.031 | 0.006 |
Ischemic heart disease (y/n) | 0.567 | 0.432–0.743 | <0.001 | 1.125 | 0.803–1.577 | 0.494 |
LVEF (by 1% p) | 1.027 | 1.017–1.038 | <0.001 | 1.014 | 1.003–1.026 | 0.013 |
Charlson co-morbidity index (by 1 point) | 0.912 | 0.875–0.951 | <0.001 | 1.033 | 0.983–1.086 | 0.203 |
Non-infectious indications for TLE (y/n) | 0.979 | 0.788–1.216 | 0.846 | |||
Abandoned leads before TLE (y/n) | 3.510 | 2.575–4.786 | <0.001 | 1.107 | 0.712–1.720 | 0.652 |
Lead loops before TLE (y/n) | 2.678 | 1.765–4.062 | <0.001 | 1.347 | 0.856–2.120 | 0.198 |
Number of the leads in the heart before TLE (by 1) | 1.526 | 1.296–1.798 | <0.001 | 1.021 | 0.804–1.298 | 0.862 |
Leads on both sides of the chest (y/n) | 1.020 | 0.980–1.062 | 0.335 | |||
Number of CIED-related procedures before TLE (by 1) | 1.692 | 1.537–1.863 | <0.001 | 1.187 | 1.033–1.364 | 0.016 |
UP lead extraction (y/n) | 4.627 | 3.377–6.341 | <0.001 | 1.197 | 0.808–1.771 | 0.370 |
Extraction of passive fixation lead (y/n) | 10.677 | 6.397–17.82 | <0.001 | 6.354 | 3.679–10.97 | <0.001 |
Sum of dwell times of all extracted leads (by 1 year) | 1.056 | 1.048–1.065 | <0.001 | |||
Number of extracted leads (by 1) | 1.784 | 1.526–2.085 | <0.001 | |||
Extraction of abandoned lead/leads (y/n) | 3.671 | 2.681–5.026 | <0.001 | |||
Extraction of looped leads (y/n) | 1.889 | 1.384–2.578 | <0.001 | |||
Dwell time of the oldest extracted lead (by 1 year) | 1.129 | 1.110–1.148 | <0.001 |
Univariable Regression Model | Multivariable Regression Model | |||||
---|---|---|---|---|---|---|
OR | 95%CI | p | OR | 95%CI | p | |
SAFeTY-TLE (by 1% p) | 1.198 | 1.160–1.237 | <0.001 | 1.029 | 0.988–1.071 | 0.171 |
EROS (by 1 point) | 2.396 | 2.036–2.819 | <0.001 | 1.081 | 0.860–1.358 | 0.505 |
MB (by 1 point) | 2.130 | 1.847–2.455 | <0.001 | 1.128 | 0.895–1.422 | 0.307 |
LED (by 1 point) | 1.129 | 1.110–1.148 | <0.001 | 1.058 | 1.024–1.094 | <0.001 |
Advanced TLE (by 1 point) | 1.605 | 1.379–1.868 | <0.001 | 1.128 | 0.898–1.416 | 0.300 |
LECOM (by 1% point) | 1.041 | 1.035–1.047 | <0.001 | 1.019 | 1.009–1.029 | <0.001 |
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Kutarski, A.; Jacheć, W.; Czajkowski, M.; Stefańczyk, P.; Kosior, J.; Tułecki, Ł.; Nowosielecka, D. Lead Break during Extraction: Predisposing Factors and Impact on Procedure Complexity and Outcome: Analysis of 3825 Procedures. J. Clin. Med. 2024, 13, 2349. https://doi.org/10.3390/jcm13082349
Kutarski A, Jacheć W, Czajkowski M, Stefańczyk P, Kosior J, Tułecki Ł, Nowosielecka D. Lead Break during Extraction: Predisposing Factors and Impact on Procedure Complexity and Outcome: Analysis of 3825 Procedures. Journal of Clinical Medicine. 2024; 13(8):2349. https://doi.org/10.3390/jcm13082349
Chicago/Turabian StyleKutarski, Andrzej, Wojciech Jacheć, Marek Czajkowski, Paweł Stefańczyk, Jarosław Kosior, Łukasz Tułecki, and Dorota Nowosielecka. 2024. "Lead Break during Extraction: Predisposing Factors and Impact on Procedure Complexity and Outcome: Analysis of 3825 Procedures" Journal of Clinical Medicine 13, no. 8: 2349. https://doi.org/10.3390/jcm13082349