Document Detail


ICD leads: design and chronic dysfunctions.
MedLine Citation:
PMID:  12710331     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The treatment of ventricular tachyarrhythmias has changed over the last 10 years. Implantable cardioverter defibrillators (ICDs), once used only as a last resort therapy, have now become the treatment of choice. This change occurred before the first results of randomized studies on ICD therapy in patients with life-threatening ventricular tachyarrhythmias were published by the end of 1997. Technological advances of ICD therapy, in particular the development of transvenous leads, were to a large extent responsible for this change. Modern leads are characterized by their multilumen design that incorporates straight wires and coiled conductors into a single electrode body. Conductors and insulation are sheathed with additional insulation layers. The most frequently used insulating materials are silicone, polyurethane, and fluoropolymers. Lead failures are an important complication of ICD therapy. Fractured conductors, compression, creeping, or insulation defects from abrasion can cause such lead dysfunctions. Chronically implanted leads will inevitably have an increased risk of failure due to defects despite all technological advances. In the light of improving survival figures in patients with ventricular tachyarrhythmias and increasing numbers of ICD implantations, lead failures are becoming a clinical problem of ever increasing importance. Therefore, the question of which lead types necessitate extraction when a certain failure occurs and which leads can be left in place. Despite continuous improvements in lead extraction systems and growing experience in their use, the extraction of any pacemaker or ICD lead is associated with some risk of complications.
Authors:
Rainer Gradaus; Günter Breithardt; Dirk Böcker
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  26     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-04-24     Completed Date:  2003-07-18     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  649-57     Citation Subset:  IM    
Affiliation:
Medizinische Klinik und Poliklinik C (Kardiologie und Angiologie), Universitätsklinikum Münster, D-48129 Münster, Germany. gradaus@uni-muenster.de
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MeSH Terms
Descriptor/Qualifier:
Defibrillators, Implantable*
Device Removal
Electrodes, Implanted*
Equipment Design
Equipment Failure
Humans

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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