Document Detail

Two different therapeutic strategies in ICD lead defects: additional combined lead versus replacement of the lead.
MedLine Citation:
PMID:  17764449     Owner:  NLM     Status:  MEDLINE    
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.
Christian G Wollmann; Dirk Böcker; Andreas Löher; Matthias Paul; Hans H Scheld; Günter Breithardt; Rainer Gradaus
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2007-08-30
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  18     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-22     Completed Date:  2007-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1172-7     Citation Subset:  IM    
Department of Cardiology and Angiology, University Hospital of Münster, Germany.
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MeSH Terms
Defibrillators, Implantable / statistics & numerical data*
Electrodes, Implanted
Equipment Design
Equipment Failure
Follow-Up Studies
Heart Diseases / mortality,  therapy*
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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