{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:15:42Z","timestamp":1790799342879,"version":"4.1.0"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,2,22]],"date-time":"2020-02-22T00:00:00Z","timestamp":1582329600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>A validated risk stratification schema for transvenous lead extraction (TLE) could improve the management of these procedures. We aimed to derive and validate a scoring system to efficiently predict the need for advanced tools to achieve TLE success.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Between November 2013 and March 2018, 1960 leads were extracted in 973 consecutive TLE procedures in two national referral sites using a stepwise approach. A procedure was defined as advanced extraction if required the use of powered sheaths and\/or snares. The study population was a posteriori 1:1 randomized in derivation and validation cohorts. In the derivation cohort, presence of more than two targeted leads (odds ratio [OR] 1.76, P\u2009=\u20090.049), 3-year-old (OR 3.04, P\u2009=\u20090.001), 5-year-old (OR 3.48, P\u2009&amp;lt;\u20090.001), 10-year-old (OR 3.58, P\u2009=\u20090.008) oldest lead, implantable cardioverter-defibrillator (OR 3.84, P\u2009&amp;lt;\u20090.001), and passive fixation lead (OR 1.91, P\u2009=\u20090.032) were selected by a stepwise procedure and constituted the MB score showing a C-statistics of 0.82. In the validation group, the MB score was significantly associated with the risk of advanced extraction (OR 2.40, 95% confidence interval 2.02-2.86, P\u2009&amp;lt;\u20090.001) and showed an increase in event rate with increasing score. A low value (threshold\u2009=\u20091) ensured 100% sensibility and 100% negative predictive value, while a high value (threshold\u2009=\u20095) allowed a specificity of 92.8% and a positive predictive value of 91.9%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In this study, we developed and tested a simple point-based scoring system able to efficiently identify patients at low and high risk of needing advanced tools during TLE procedures.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euaa027","type":"journal-article","created":{"date-parts":[[2020,1,22]],"date-time":"2020-01-22T04:28:45Z","timestamp":1579667325000},"page":"613-621","source":"Crossref","is-referenced-by-count":35,"title":["The MB score: a new risk stratification index to predict the need for advanced tools in lead extraction procedures"],"prefix":"10.1093","volume":"22","author":[{"given":"Luca","family":"Bontempi","sequence":"first","affiliation":[{"name":"Division of Cardiology, Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Curnis","sequence":"first","affiliation":[{"name":"Division of Cardiology, Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Della Bella","sequence":"first","affiliation":[{"name":"Arrhythmology Unit, San Raffaele Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Cerini","sequence":"first","affiliation":[{"name":"Division of Cardiology, Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Radinovic","sequence":"first","affiliation":[{"name":"Arrhythmology Unit, San Raffaele Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenza","family":"Inama","sequence":"first","affiliation":[{"name":"Division of Cardiology, Manerbio Hospital, Manerbio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Melillo","sequence":"first","affiliation":[{"name":"Arrhythmology Unit, San Raffaele Hospital, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Salghetti","sequence":"first","affiliation":[{"name":"Division of Cardiology, Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Marzi","sequence":"first","affiliation":[{"name":"Arrhythmology Unit, San Raffaele 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