| Necessity for surgical revision of defibrillator leads implanted long-term: causes and management. | |
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MedLine Citation:
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PMID: 18490526 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Defibrillator lead malfunction is a potential long-term complication in patients with an implantable cardioverter-defibrillator (ICD). The aim of this study was to determine the incidence and causes of lead malfunction necessitating surgical revision and to evaluate 2 approaches to treat lead malfunction. METHODS AND RESULTS: We included 1317 consecutive patients with an ICD implanted at 3 European centers between 1993 and 2004. The types and causes of lead malfunction were recorded. If the integrity of the high-voltage part of the lead could be ascertained, an additional pace/sense lead was implanted. Otherwise, the patients received a new ICD lead. Of the 1317 patients, 38 experienced lead malfunction requiring surgical revision and 315 died during a median follow-up of 6.4 years. At 5 years, the cumulative incidence was 2.5% (95% confidence interval, 1.5 to 3.6). Lead malfunction resulted in inappropriate ICD therapies in 76% of the cases. Implantation of a pace/sense lead was feasible in 63%. Both lead revision strategies were similar with regard to lead malfunction recurrence (P=0.8). However, the cumulative incidence of recurrence was high (20% at 5 years; 95% confidence interval, 1.7 to 37.7). CONCLUSIONS: ICD lead malfunction necessitating surgical revision becomes a clinically relevant problem in 2.5% of ICD recipients within 5 years. In selected cases, simple implantation of an additional pace/sense lead is feasible. Regardless of the chosen approach, the incidence of recurrent ICD lead-related problems after lead revision is 8-fold higher in this population. |
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Authors:
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Jens Eckstein; Michael T Koller; Markus Zabel; Dietrich Kalusche; Beat A Schaer; Stefan Osswald; Christian Sticherling |
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Publication Detail:
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Type: Journal Article; Multicenter Study Date: 2008-05-19 |
Journal Detail:
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Title: Circulation Volume: 117 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-05-28 Completed Date: 2008-06-30 Revised Date: 2009-02-06 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 2727-33 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Defibrillators, Implantable / adverse effects*, statistics & numerical data* Electrodes, Implanted / adverse effects, statistics & numerical data Equipment Failure / statistics & numerical data* Female Follow-Up Studies Heart Arrest / epidemiology Humans Incidence Male Middle Aged Reoperation / statistics & numerical data* Retrospective Studies Tachycardia / epidemiology*, surgery*, therapy Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Circulation. 2009 Jan 6;119(1):e8; author reply e9
[PMID:
19124671
]
Circulation. 2008 May 27;117(21):2721-3 [PMID: 18506015 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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