Ann Cardiol Cardiovasc Med | Volume 5, Issue 1 | Research Article | Open Access
Roman Brenner*, Joelle Hüppi, David Altmann, Micha T. Maeder, Hans Rickli and Peter Ammann
Department of Cardiology, Kantonsspital St. Gallen, Switzerland
*Correspondance to: Roman BrennerFulltext PDF
Purpose: Revisions of Internal Cardioverter Defibrillator (ICD) leads are associated with increased morbidity and mortality. Data regarding lead performances in different studies depend on lead failure definition. The aim of this study was to assess the lead revision rate of four contemporary ICD leads.
Methods: Data on ICD lead revisions at a single centre was retrospectively assessed between 2004 and 2016. The incidence rate of lead revision of four ICD leads (Medtronic Sprint Quattro [SQ], Medtronic Sprint Fidelis [SF], Biotronik Linox [BL] and Boston Scientific Endotak Reliance [ER]) was compared. The primary endpoint was clinically indicated lead revisions (inacceptable electric parameters, non-physiological oversensing).
Results: Overall, 529 leads in 497 patients were observed (53.1% SQ, 10.8% SF, 14.4% BL and 21.7% ER). Sixteen leads had a primary endpoint during a median (interquartile range) follow-up of 3.5 (1.0, 6.4) years. The cumulative incidence of lead revisions was significantly higher in passive vs. active leads (10.2 vs. 1.1%, HR: 4.9 [95% CI 2.0, 11.7], p<0.001) and was 0.7%, 10.5%, 0% and 7.0% for SQ, SF, BL and ER (p=0.007) with a significantly higher Hazard Ratio (HR) for SF (HR: 8.9 [95% CI 1.8, 44.5], p=0.008) and ER (HR: 6.3 [95% CI 1.3, 29.8], p=0.021) compared to SQ leads (referent).
Conclusion: A strategy of early, clinically indicated ICD lead revisions might be associated with a higher rate of lead revisions in passive compared to active and in ER compared to SQ ICD leads.
ICD leads; ICD lead failure; ICD lead revision; ICD lead performance; Endotak Reliance; ICD lead survival
Brenner R, Hüppi J, Altmann D, Maeder MT, Rickli H, Ammann P. Clinically Indicated Lead Revision Rates for Four Different Internal Cardioverter-Defibrillator Lead Models. Ann Cardiol Cardiovasc Med. 2021;5(1):1043..