Is the use of an additional pace/sense lead the optimal strategy for the avoidance of lead extraction in defibrillation lead failure? A single-centre experience.
OBJECTIVE
The implantation of an additional pace-sense (P/S) lead is a standard treatment option in the management of an isolated pace-sense problem in a defibrillation (HV-P/S) lead. However, the safety of this management strategy is unclear. We performed a retrospective single-centre study to assess this.


RESULTS
We studied all patients with an isolated P/S problem in an HV-P/S lead, treated with an additional P/S lead, in our institution. The need for further invasive intervention for a lead-related complication, or death during follow-up, was assessed. From 2000 to 2008, 45 patients were treated with an additional P/S lead. Mean follow-up was 78 +/- 38 months from original device implantation and 28 +/- 17 months following implantation of the additional lead. During follow-up, three patients required an invasive intervention for a lead-related problem. All were successfully treated with lead extraction and device re-implantation. There were five deaths. Following implant of an additional lead, cumulative survival from further lead defects after 6 months, 1, 2, and 3 years was 100, 100, 93, and 87%, respectively.


CONCLUSIONS
In the treatment of an isolated P/S problem in an HV-P/S lead, the placement of an additional P/S lead is a safe management strategy, at least in the short term.
Scott
Paul A
PA
Wessex Cardiothoracic Unit, Southampton University Hospitals NHS Trust, Tremona Road, Southampton SO166YD, UK. paul.andrew.scott@btinternet.com
Chungh
Aman
A
Zeb
Mehmood
M
Yue
Arthur M
AM
Roberts
Paul R
PR
Morgan
John M
JM
D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000401:mortality / Q000628:therapy*; D017147:Defibrillators, Implantable / Q000009:adverse effects* / Q000706:statistics & numerical data; D004567:Electrodes, Implanted / Q000009:adverse effects* / Q000706:statistics & numerical data; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D012189:Retrospective Studies