| Do abandoned leads pose risk to implantable cardioverter-defibrillator patients? | |
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MedLine Citation:
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PMID: 19121802 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: With the increased number of implantable cardioverter-defibrillator (ICD) recipients and the frequent need for device upgrading, lead malfunction is a concern, but the optimal approach to managing nonfunctioning leads is unknown. OBJECTIVE: The purpose of this study was to determine the rate and characteristics of complications related to abandoned ICD leads. METHODS: Patients with abandoned leads were identified by retrospective review of the Mayo Clinic ICD database from August 1993 to May 2002. We reviewed the medical records to assess long-term follow-up for venous thromboembolic complications, device sensing malfunction, appropriateness of delivered shocks, defibrillation threshold (DFT) values before and after lead abandonment, and subsequent surgical procedures related to devices or leads. RESULTS: We identified 78 ICD patients (81% males; mean age 63 +/- 14 years) with 101 abandoned leads (69 in the right ventricle, 31 in the right atrium or superior vena cava, 1 in the coronary sinus). During a mean follow-up of 3.1 +/- 2.0 years, neither sensing malfunction nor venous thromboembolic complications were detected. DFT values were high in 13 patients (17%), but there was no significant increase in mean DFT values before and after lead abandonment in 43 patients for whom both values were available (16.2 +/- 9.2 J before abandonment vs 14.1 +/- 5.5 J after; P = .24). Fourteen patients (18%) required further ICD-related surgery; none of these operations were attributed to abandoned leads. Five-year rates of appropriate and inappropriate shocks were 25.9% and 20.5%, respectively. CONCLUSION: Abandoning a nonfunctioning lead appears to be safe and does not pose a clinically significant additional risk of future complications. |
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Authors:
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Michael Glikson; Mahmoud Suleiman; David M Luria; Marjorie L Martin; David O Hodge; Win-Kuang Shen; David J Bradley; Thomas M Munger; Robert F Rea; David L Hayes; Stephen C Hammill; Paul A Friedman |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2008-10-11 |
Journal Detail:
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Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: 6 ISSN: 1556-3871 ISO Abbreviation: Heart Rhythm Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2009-01-05 Completed Date: 2009-04-21 Revised Date: 2009-10-27 |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
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Languages: eng Pagination: 65-8 Citation Subset: IM |
Affiliation:
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Sheba Medical Center and Tel Aviv University, Tel Hashomer, Israel. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Arrhythmias, Cardiac
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therapy* Defibrillators, Implantable / adverse effects* Electric Countershock / instrumentation* Endocardium / surgery* Equipment Design Equipment Failure Equipment Safety Female Follow-Up Studies Humans Male Middle Aged Prognosis Retrospective Studies Risk Assessment Risk Factors Thromboembolism / etiology, prevention & control* Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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