| Two different therapeutic strategies in ICD lead defects: additional combined lead versus replacement of the lead. | |
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MedLine Citation:
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PMID: 17764449 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Implantation of an additional HV-P/S lead versus extraction of the defective HV-P/S lead and implantation of a new one is one possible therapeutic approach in cases of a defective high-voltage pace/sense lead (HV-P/S). No information is available on potential differences in clinical outcome in these different approaches. METHODS: Between January 2000 and February 2006, 86 patients with HV-P/S lead defect received either an additional transvenous HV-P/S lead (n = 33, group 1) or the HV-P/S lead was replaced (n = 53, group 2). The duration of the initially implanted leads was significantly different in the two groups (7.4 +/- 2.9; group 1 and 4.1 +/- 3.4 years; group 2). The outcome of these two groups of patients was retrospectively analyzed. RESULTS: Seventy-three patients [85%] survived until the end of follow-up of 29 +/- 15 (group 1) and 33 +/- 21 (group 2) months (P = ns), respectively. Thirteen patients died: six in group 1 and seven in group 2 (P = ns). Fourteen patients experienced perioperative complications (group 1: six; group 2: eight; P = ns). ICD system-related complications occurred in 22 patients (group 1: seven; group two: 15; P = ns). The event-free cumulative survival of patients with additional and replaced HV-P/S lead for postoperative events (including death) after 1, 2, and 3 years was 82%, 70%, 70%, and 86%, 81%, 66%, respectively (P = 0.93). CONCLUSIONS: Implantation of an additional HV-P/S lead or replacement of the HV-P/S lead in case of HV-P/S lead failure is statistically not different concerning mortality and morbidity. There are no predictors for further lead defects. Implantation of an additional HV-P/S lead should not be recommended in young patients or patients with greater likelihood of living many years. Predictors for death were an age over 70 years and renal insufficiency. |
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Authors:
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Christian G Wollmann; Dirk Böcker; Andreas Löher; Matthias Paul; Hans H Scheld; Günter Breithardt; Rainer Gradaus |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2007-08-30 |
Journal Detail:
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Title: Journal of cardiovascular electrophysiology Volume: 18 ISSN: 1540-8167 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 2007 Nov |
Date Detail:
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Created Date: 2007-10-22 Completed Date: 2007-12-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 1172-7 Citation Subset: IM |
Affiliation:
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Department of Cardiology and Angiology, University Hospital of Münster, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Defibrillators, Implantable
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statistics & numerical data* Electrodes, Implanted Equipment Design Equipment Failure Female Follow-Up Studies Heart Diseases / mortality, therapy* Humans Male Middle Aged Perioperative Care / methods Prosthesis Implantation / methods*, mortality* Retrospective Studies Survival Rate Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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