Lead extraction: Definition standards

We have read with great interest the article entitled “Cardiac implantable electronic device lead extraction using the lead-locking device system: keeping it simple, safe, and inexpensive with mechanical tools and local anesthesia” by Manolis et al. in the latest issue of the Journal (1). The authors have presented their experiences regarding lead extraction using locking stylet. However, some important issues should be mentioned. Manuscripts regarding cardiac implantable electronic devices and their removal should contain standard definitions to avoid confusion; some of such important definitions include Lead Removal (the removal of any lead using any technique), Lead Explant (the removal of any lead with <1 year implant time using simple traction without specialized tools other than simple stylets), and Lead Extraction [the removal of any lead using specialized extraction tools, removal from a route other than via the implant vein, or any lead with >1 year implant time (2, 3)]. In the current study, reported time range since implantation was 0.3–19 years; thus, there were some leads with <1 year implant time (although locking stylets may have been implemented in some leads with <1 year implant time), and 6 leads were removed with simple traction as stated by the authors