{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:03:14Z","timestamp":1788498194549,"version":"build-2803163510"},"reference-count":35,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007771","name":"Medical University of Silesia","doi-asserted-by":"publisher","award":["BNW-2-073\/N\/3\/K"],"award-info":[{"award-number":["BNW-2-073\/N\/3\/K"]}],"id":[{"id":"10.13039\/100007771","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The lead breakage (LB) during transvenous lead extraction (TLE) increases procedural complexity, increases the risk of complications, and decreases procedural efficiency. This study aimed to identify protective and risk factors for the breakage of cardiac electronic device leads during extraction. Methods: Data were sourced from the EXTRACT prospective registry for TLE procedures conducted between January 2016 and June 2025. A total of 702 consecutive TLE procedures involving 1375 leads were enrolled. Multivariate logistic regression was used to identify independent protective and risk factors and develop a model to predict the occurrence of LB during TLE. Results: In the analysed group, 56 (7.98%) of 702 TLE procedures were disrupted by the breakage of at least one lead. The model showed a lower lead breakage rate in procedures when an atrial lead was simultaneously extracted, a locking stylet was used, and when the procedure was conducted in older patients or those who had undergone prior cardiac surgery. Higher risk of LB was proven in the following cases: the extraction of leads implanted a long time ago; the extraction of VDD-type leads; the extraction of abandoned leads; extraction during a prolonged procedure. Occurrence of lead breakage may lead to pericardial effusion requiring intervention, acute kidney injury, or leaving remnants of the leads. Conclusions: Lead breakage is an underestimated procedural difficulty that can occur during transvenous lead extraction. In this study, several clinical and procedural variables were independently associated with lead breakage. Abandoned leads, VDD leads, and prolonged procedure time were associated with increased risk. In contrast, older age, use of a locking stylet, atrial lead extraction, prior cardiac surgery, and later year of implantation demonstrated independent protective associations.<\/jats:p>","DOI":"10.3390\/jcm15031216","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T12:51:56Z","timestamp":1770209516000},"page":"1216","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Transvenous Lead Extraction Complicated by Lead Breakage: A Predictive Model Based on Analysis of the EXTRACT Registry"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0562-9695","authenticated-orcid":false,"given":"Michal","family":"Joniec","sequence":"first","affiliation":[{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, Ziolowa 45\/47 Str., 40-635 Katowice, Poland"},{"name":"Doctoral School of the Medical University of Silesia in Katowice, Poniatowskiego 15 Str., 40-055 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Stachanczyk","sequence":"additional","affiliation":[{"name":"Department of Cardiac Rehabilitation, Murcki Hospital, 40-749 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0002-1955","authenticated-orcid":false,"given":"Rafal","family":"Gardas","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, Ziolowa 45\/47 Str., 40-635 Katowice, Poland"},{"name":"Department of Electrocardiology and Heart Failure, Medical University of Silesia in Katowice, Ziolowa 45\/47 Str., 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8770-8321","authenticated-orcid":false,"given":"Sylwia","family":"Gladysz-Wanha","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, Ziolowa 45\/47 Str., 40-635 Katowice, Poland"},{"name":"Doctoral School of the Medical University of Silesia in Katowice, Poniatowskiego 15 Str., 40-055 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugeniusz","family":"Pilat","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, Ziolowa 45\/47 Str., 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Drzewiecka","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, Ziolowa 45\/47 Str., 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta","family":"Biernat","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, Ziolowa 45\/47 Str., 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Weglarzy","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anaesthesia and Intensive Care, Upper-Silesian Medical Centre in Katowice, Ziolowa 45\/47 Str., 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1220-9496","authenticated-orcid":false,"given":"Wojciech","family":"Wanha","sequence":"additional","affiliation":[{"name":"Third Department of Cardiology, Upper-Silesian Medical Centre in Katowice, Ziolowa 45\/47 Str., 40-635 Katowice, Poland"},{"name":"Department of Cardiology and Structural Heart Diseases, Medical University of Silesia in Katowice, Poniatowskiego 15 Str., 40-055 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2932-6269","authenticated-orcid":false,"given":"Danuta","family":"Loboda","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, Ziolowa 45\/47 Str., 40-635 Katowice, Poland"},{"name":"Department of Electrocardiology and Heart Failure, Medical University of Silesia in Katowice, Ziolowa 45\/47 Str., 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5722-7976","authenticated-orcid":false,"given":"Krzysztof S.","family":"Golba","sequence":"additional","affiliation":[{"name":"Department of Electrocardiology, Upper-Silesian Medical Centre in Katowice, Ziolowa 45\/47 Str., 40-635 Katowice, Poland"},{"name":"Department of Electrocardiology and Heart Failure, Medical University of Silesia in Katowice, Ziolowa 45\/47 Str., 40-635 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1016\/j.hrthm.2025.05.002","article-title":"Top stories on lead extraction: Key publications from 2023 to 2025","volume":"22","author":"Bongiorni","year":"2025","journal-title":"Heart Rhythm"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.hrthm.2023.12.015","article-title":"Transvenous lead extraction safety and efficacy in infected and noninfected patients using mechanical-only tools: Prospective registry from a high-volume center","volume":"21","author":"Joniec","year":"2024","journal-title":"Heart Rhythm"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1001\/jamacardio.2023.3379","article-title":"Lead Extraction and Mortality Among Patients with Cardiac Implanted Electronic Device 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