Predictive factors of lead failure in patients implanted with cardiac devices

Yoshiyasu Aizawa, Masachika Negishi, Shin Kashimura, Kazuaki Nakajima, Akira Kunitomi, Yoshinori Katsumata, Takahiko Nishiyama, Takehiro Kimura, Nobuhiro Nishiyama, Kotaro Fukumoto, Yoko Tanimoto, Shun Kosaka, Seiji Takatsuki, Keiichi Fukuda

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13 Citations (Scopus)

Abstract

Introduction Lead failures (LFs) are one of the most common complications in patients implanted with cardiovascular implantable electronic devices. LFs often cause serious secondary complications such as inappropriate ICD shocks or asystole. This study aimed to identify the clinical factors associated with the occurrence of LFs. Methods A total of 735 consecutive device implantations (mean age 67 ± 15 years, males 64%) performed at a single university hospital setting from 1997 to 2014 were included. The implanted devices consisted of 421 pacemakers, 250 implantable cardioverter defibrillators (ICD), 9 cardiac resynchronization therapy pacemakers (CRT-P), and 55 CRT defibrillators (CRT-D). The primary endpoint was the development of an LF. Results During a mean duration of 5.8 ± 4.3 years, 38 LFs developed in 31 patients (mean age 56 ± 14 years). LFs included 32 ICD (7 Sprint Fidelis, 2 Riata), and 6 pacing leads. Nine patients received inappropriate ICD shocks and 1 had syncope due to an LF. All patients underwent lead reinsertions with device replacements. Eight patients required opposite site implantations due to venous occlusions. The predictive factors of LFs were the age, male sex, taller body length, ICD vs. pacemaker, lesser lead number, extra-thoracic puncture of the axillary vein vs. a cut-down of the cephalic vein, use of recalled leads and patients with idiopathic ventricular fibrillation (IVF) and Brugada syndrome (BrS). Conclusion LFs occurred mainly with ICD leads. A lesser age, the puncture method, lead model, and diagnosis of IVF/BrS were associated with the development of LFs.

Original languageEnglish
Pages (from-to)277-281
Number of pages5
JournalInternational Journal of Cardiology
Volume199
DOIs
Publication statusPublished - 2015 Sep 15

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Keywords

  • Brugada syndrome
  • Fidelis
  • Idiopathic ventricular fibrillation
  • Implantable cardioverter defibrillator
  • Lead failure
  • Pacemaker
  • Riata

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Aizawa, Y., Negishi, M., Kashimura, S., Nakajima, K., Kunitomi, A., Katsumata, Y., Nishiyama, T., Kimura, T., Nishiyama, N., Fukumoto, K., Tanimoto, Y., Kosaka, S., Takatsuki, S., & Fukuda, K. (2015). Predictive factors of lead failure in patients implanted with cardiac devices. International Journal of Cardiology, 199, 277-281. https://doi.org/10.1016/j.ijcard.2015.07.055