Long-term follow-up of transvenous defibrillation leads: high incidence of fracture in coaxial polyurethane lead.
BACKGROUND
As a result of longer follow-up after implantation of cardioverter defibrillators (ICD), fatigue of the leads has become a concern. The aim of this study was to determine the incidence and clinical presentation of ICD lead failures.


RESULTS
The study population consisted of 241 patients with 249 ICD leads who underwent implantation of an ICD with a transvenous lead system. After device implantation, the patients were routinely followed up every 4 months. Five lead failures (2.0%) occurred as an oversensing of artifact during the follow-up period (2.6+/-2.1 years); 4 of those 5 patients received inappropriate shocks and 1 case of lead failure was identified in a patient with frequent episodes of non-sustained ventricular fibrillation. In particular, the right ventricular polyurethane transvenous lead in the Medtronic model 6936 failed in 4 (13%) of 31 cases. Percutaneous lead extraction was not available in all cases, so an additional ICD lead was inserted through the same site of the subclavian vein.


CONCLUSIONS
Lead failures may occur 5 years after ICD implantation and polyurethane leads have an especially high incidence of failure. However, there were no follow-up parameters observed that predicted lead failures.
Kitamura
Satoko
S
Department of Cardiovascular Medicine, National Cardiovascular Center, Suita, Japan.
Satomi
Kazuhiro
K
Kurita
Takashi
T
Shimizu
Wataru
W
Suyama
Kazuhiro
K
Aihara
Naohiko
N
Niwaya
Kazuo
K
Kobayashi
Junjiro
J
Kamakura
Shiro
S
D000328:Adult; D000368:Aged; D003627:Data Interpretation, Statistical; D017147:Defibrillators, Implantable / Q000592:standards*; D004554:Electric Countershock / Q000295:instrumentation*; D004559:Electric Wiring / Q000295:instrumentation* / Q000592:standards*; D019544:Equipment Failure Analysis / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011140:Polyurethanes; D013997:Time Factors
D011140:Polyurethanes