Clinical and radiographic predictors of cardiovascular implantable electronic device lead failure at the time of initial implantation.

Autor: Kim EJ; Department of Medicine Division of Cardiovascular Medicine University of California San Francisco San Francisco CA USA., Davogustto G; Department of Medicine Division of Cardiovascular Medicine Vanderbilt University Medical Center Nashville TN USA., Huang S; Vanderbilt University Medical Center Department of Biostatistics Vanderbilt University Medical Center Nashville TN USA., Crossley GH 3rd; Department of Medicine Division of Cardiovascular Medicine Vanderbilt University Medical Center Nashville TN USA., Montgomery JA; Department of Medicine Division of Cardiovascular Medicine Vanderbilt University Medical Center Nashville TN USA.
Jazyk: angličtina
Zdroj: Journal of arrhythmia [J Arrhythm] 2021 Jun 07; Vol. 37 (4), pp. 1086-1092. Date of Electronic Publication: 2021 Jun 07 (Print Publication: 2021).
DOI: 10.1002/joa3.12559
Abstrakt: Objective: To assess the clinical and radiographic factors associated with lead failure by comparing subjects with lead failure within 10 years of implantation with an implant-year-matched group without lead failure.
Methods: A case-control study with 49 subjects who received Cardiac Implantable Electronic Device (CIED) between January 1, 1999 and July 31, 2008 and developed lead failure within 10 years of implantation in a single center. The control group consisted of subjects (n = 54) with normally functioning leads matched one-to-one by implant year.
Results: Among the failure group, the meantime from implantation to device lead failure was 4.70 ± 2.94 years. Older age at implantation was associated with a lower likelihood of lead failure (Odds Ratio (OR) = 0.28 (75 vs 42 years old), 95% CI 0.12-0.63, P  = .002). A larger smallest loop diameter on the chest radiograph was also associated with a lower likelihood of lead failure (OR = 0.51 (31 vs 14 mm), 95% CI 0.27-0.97, P  = .04). CIED type (defibrillator vs pacemaker) and Ottawa scores were not significantly associated with lead failure. Among lead-specific parameters, defibrillation lead vs pace-sense lead was associated with lead failure (OR = 3.91, 95% CI 1.95-7.81, P  < .001).
Conclusions: Younger age, defibrillation leads, and small lead loops are associated with lead failure in CIEDs. Techniques to avoid tight loops in the pocket could potentially reduce the risk of lead failure and bear important implications for the implanting physician.
Competing Interests: Dr George Crossley has served as a consultant for Medtronic and Boston Scientific and as a speaker for Medtronic. Dr Jay Montgomery has served as a consultant for Medtronic. None of the other authors have disclosures.
(© 2021 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.)
Databáze: MEDLINE
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