The Original Break
In 553 by council, the bishops of Aquileia, Liguria, Aemilia, Milan and of the Istrian peninsula all refused to condemn the Three Chapters, arguing that to do so would be to betray Chalcedon. They broke off communion with Rome, under the leadership of Macedonius of Aquileia (535-556).
They in turn were anathematized by other churchmen.
The schism provided the opportunity for the bishop of Aquileia to assume the title Patriarch. Macedonius' successor Paulinus I (557-569) began using the title around 560.
Read more about this topic: Schism Of The Three Chapters
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