Abstract
The implantable cardioverter-defibrillator (ICD) has been shown to decrease the risk of sudden cardiac death in patients when used for primary and secondary prevention. These devices are being used more frequently as indications for primary prevention broaden, and attention has become increasingly focused on complications caused by lead failure. A report using data from a large registry revealed that the cumulative incidence of lead malfunction that necessitated surgical revision of the ICD lead system was 2.5% over 5 years. A strategy to deal with failed leads by the implantation of new pace–sense leads or high-voltage leads resulted in a 20% malfunction recurrence rate at 5 years. Defibrillator leads have been termed the 'weakest link' in the ICD system. Further efforts from manufacturers, regulators, and implanting physicians are required to understand and address the causes of lead failure.
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References
Mirowski M et al. (1980) Termination of malignant ventricular arrhythmias with an implanted automatic defibrillator in human beings. N Engl J Med 303: 322–324
Brown DW et al. (2008) Trends in hospitalization for the implantation of cardioverter-defibrillators in the United States, 1990–2005. Am J Cardiol 101: 1753–1755
Kleemann T et al. (2007) Annual rate of transvenous defibrillation lead defects in implantable cardioverter-defibrillators over a period of >10 years. Circulation 115: 2474–2480
Daubert JP et al. (2008) Inappropriate implantable cardioverter-defibrillator shocks in MADIT II: frequency, mechanisms, predictors, and survival impact. J Am Coll Cardiol 51: 1357–1365
Hauser RG and Kallinen L (2004) Deaths associated with implantable cardioverter defibrillator failure and deactiviation reported in the United States Food and Drug Administration Manufacturer and User Facility Device Experience Database. Heart Rhythm 1: 399–405
Maisel WH (2007) Transvenous implantable cardioverter-defibrillator leads: the weakest link. Circulation 115: 2461–2463
Eckstein J et al. (2008) Necessity for surgical revision of defibrillator leads implanted long-term: causes and management. Circulation 117: 2727–2733
Kallinen LM et al. (2008) Failure of impedance monitoring to prevent adverse clinical events caused by fracture of a recalled high-voltage implantable cardioverter-defibrillator lead. Heart Rhythm 5: 775–779
Lloyd MS et al. (2008) More late perforations with the Riata defibrillator lead from a high-volume center: an update on the numbers. Pacing Clin Electrophysiol 31: 784–785
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Brinker, J. Implantable cardioverter-defibrillator lead failure: how weak is the link?. Nat Rev Cardiol 5, 758–759 (2008). https://doi.org/10.1038/ncpcardio1367
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DOI: https://doi.org/10.1038/ncpcardio1367
