{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T19:10:36Z","timestamp":1769109036598,"version":"3.49.0"},"reference-count":18,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T00:00:00Z","timestamp":1569196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>An internal risk stratification algorithm was developed to decrease the risk of major adverse cardiac events (MACEs) during lead extractions (LEs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To report upon the impact of a risk stratification algorithm (RISE [RIsk Stratification prior to lead Extraction] protocol) on outcomes of LEs in a high\u2010volume center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of a prospectively maintained LEs database was performed to identify features associated with MACEs. On the basis of the retrospective data, the RISE protocol differentiated LEs procedures into \u201cHigh\u201d and \u201cLow\u201d risk for occurrence of MACEs. High\u2010risk LEs included dual\u2010coil defibrillator lead (\u22653 years), pacemaker and single\u2010coil lead (\u22655 years), and any StarFix coronary sinus lead. During the prospective evaluation of the RISE protocol, \u201cHigh\u2010risk\u201d LEs were performed in an operating room (OR) or hybrid laboratory with the cardiac anesthesiologist, OR nursing team, perfusionist in the room, and a cardiac surgeon on the premises. \u201cLow\u2010risk\u201d LEs were performed in the electrophysiology (EP) laboratory with anesthesia provided by EP nursing team. The preintervention (pre\u2010RISE) and postintervention (post\u2010RISE) group spanned 19 and 40 months and consisted of 449 (632 leads) and 751 patients (1055 leads), respectively. The primary outcome of MACEs in the two groups was compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Protocol compliance was 100%. The primary outcome of MACEs occurred in 15 patients (3.34%) before and 12 (1.6%) after implementation of the RISE protocol (<jats:italic>P<\/jats:italic>\u2009=\u2009.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>RISE identified a low\u2010risk group where minimal resources are needed and allowed for rapid intervention in the high\u2010risk group that reduced the consequences of MACEs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14151","type":"journal-article","created":{"date-parts":[[2019,9,10]],"date-time":"2019-09-10T04:10:20Z","timestamp":1568088620000},"page":"2453-2459","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["RIsk Stratification prior to lead Extraction and impact on major intraprocedural complications (RISE protocol)"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3343-7618","authenticated-orcid":false,"given":"Muhammad R.","family":"Afzal","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiovascular Medicine Wexner Medical Center at the Ohio State University Medical Center  Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3580-2092","authenticated-orcid":false,"given":"Emile G.","family":"Daoud","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiovascular Medicine Wexner Medical Center at the Ohio State University Medical Center  Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Matre","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiovascular Medicine Wexner Medical Center at the Ohio State University Medical Center  Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abigail","family":"Shoben","sequence":"additional","affiliation":[{"name":"Department of Public Health, Division of Biostatistics, College of Public Health The Ohio State University  Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Burnside","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiovascular Medicine Wexner Medical Center at the Ohio State University Medical Center  Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney","family":"Gilliam","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiovascular Medicine Wexner Medical Center at the Ohio State University Medical Center  Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Pinkhas","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiovascular Medicine Wexner Medical Center at the Ohio State University Medical Center  Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshimasa","family":"Okabe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiovascular Medicine Wexner Medical Center at the Ohio State University Medical Center  Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaret","family":"Tyler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiovascular Medicine Wexner Medical Center at the Ohio State University Medical Center  Columbus 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