Interpreting Device Diagnostics for Lead Failure

Heart Rhythm ◽  
2021 ◽  
Author(s):  
Charles D. Swerdlow ◽  
Sylvain Ploux ◽  
Jeanne E. Poole ◽  
Sandeep G. Nair ◽  
Adam Himes ◽  
...  
Keyword(s):  
Lead Failure

Incidence of Premature Lead Failure in 2088 TendrilTM Pacing Leads: A Single Centre Experience

2020 ◽  
Author(s):  
Louise Segan ◽  
Rohit Samuel ◽  
Michael Lim ◽  
Daryl Ridley ◽  
Jonathan Sen ◽  
...  
Keyword(s):  
Single Centre ◽  
Lead Failure ◽  
Single Centre Experience ◽  
Pacing Leads

scholarly journals RIATA LEAD EXTRACTION: LEAD FAILURE DOES NOT INCREASE DIFFICULTY

2016 ◽  
Vol 67 (13) ◽  
pp. 815
Author(s):  
Ankur Tiwari ◽  
Faiz Subzposh ◽  
Ashwani Gupta ◽  
Eduard Koman ◽  
James McCaffrey ◽  
...  
Keyword(s):  
Lead Extraction ◽  
Lead Failure

scholarly journals 96-42: Comparison of lead failure rates between DF-1 and DF-4 ICD leads in clinical practice

EP Europace ◽  
2016 ◽  
Vol 18 (suppl_1) ◽  
pp. i71-i71
Author(s):  
Thomas Kleemann ◽  
Florian Nonnenmacher ◽  
Kleopatra Kouraki ◽  
Margit Strauss ◽  
Nicolaus Werner ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Failure Rates ◽  
Lead Failure ◽  
Icd Leads

Abstract 11945: Indications and Outcomes Following Transvenous Extraction of ICD versus Pacemaker Leads

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Eric W Black-Maier ◽  
Sean D Pokorney ◽  
Robert K Lewis ◽  
Alexander Christian ◽  
Ruth A Greenfield ◽  
...  
Keyword(s):  
Adverse Events ◽  
Dwell Time ◽  
Clinical Success ◽  
Lead Extraction ◽  
Index Hospitalization ◽  
Lead Failure ◽  
Icd Leads ◽  
Pacemaker Leads ◽  
Pacing Lead ◽  
Major Adverse Events

Introduction: Percutaneous transvenous lead extraction of cardiovascular implantable electronic devices (CIEDs) is increasingly common. Although ICD leads are widely considered to be more difficult to extract than pacemaker leads, there are few direct comparisons. Methods/Results: Using a cohort of 368 consecutive patients undergoing lead extraction (dwell time >1 year) between 2005-2012, we compared baseline characteristics/outcomes in extractions involving pacing versus ICD leads. We defined major adverse events (MAE) as any events/complications that required procedural intervention, transfusion, or that resulted in death or serious harm during index hospitalization. Median age was 60.6 yrs and 29.6% were women. There were 136 (37%) pacing lead extractions and 232 (63%) ICD lead extractions. Pacing leads had a longer dwell time (6.14 yrs [IQR 1.2-10.9 ] versus 4.4 yrs [IQR 1.1-6.4], p<0.001) and higher median LVEF (55% [IQR 35-55] vs. 30% [IQR 20-40], p<0.001) compared with ICD lead patients. Indications for pacing and ICD lead extractions included sepsis/endocarditis (21.3% vs. 24.6%, p=0.48), pocket infection (40.4% vs. 34.9%, p=0.29), and lead failure (15.4% vs. 38.8%, p<0.001). There were no significant differences between pacing and ICD lead extractions in median fluoroscopy time (5.5 vs. 8.5 minutes, p=0.86) or femoral bailout rate (4.4% vs. 5.2%, p=0.73). There were similar rates of all-cause MAE during index hospitalization (5.1% vs. 5.6%), death (2.2% vs 3.2%) and clinical success (97.0% vs. 97.0%, p=0.55) in pacemaker and ICD extractions, respectively. Conclusions: ICD leads are more commonly extracted relative to pacemaker leads, and this difference is driven by larger numbers of lead failure within ICD leads. Despite much longer dwell times, major adverse events were similar in pacing lead cases compared with ICD extractions.

Abstract 13531: Coronary Artery Disease Predicts Venous Occlusion in Patients Undergoing Lead Extraction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Kris Kumar ◽  
Stacey Howell ◽  
Saket Sanghai ◽  
George Giraud ◽  
Peter Jessel ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Odds Ratio ◽  
Nyha Class ◽  
Vascular Occlusion ◽  
Venous Occlusion ◽  
Lead Extraction ◽  
Lead Failure ◽  
Increased Risk ◽  
Artery Disease

Introduction: Pacemaker and ICD lead failure or vascular occlusion can require lead extraction. Predictors of a need for lead extraction due to venous occlusion are not well characterized. Hypothesis: Coronary artery disease (CAD) is an independent predictor of lead extraction due to venous occlusion. Methods: We performed a retrospective study of consecutive patients in a prospectively collected registry at a single center undergoing lead extraction due to either venous occlusion or lead failure from 10/2011 to 02/2020. Patients requiring lead extraction due to infection were excluded. Continuous variables are reported as mean ± standard deviation or total number reported as a percentage (%). Chi square test and logistic regression were used to estimate difference in rates and Odds Ratio. Statistically significant findings were identified with a p valve < 0.05. Results: Of 384 procedures included in the database, 131 patients met inclusion criteria for venous occlusion (17%) or lead failure (83%) (Table 1). Average age of the cohort was 55.1 ± 16.4 years and 51% were female. Baseline ejection fraction was 44.6 ± 15.5% and 19.7% of patients had NYHA class III or IV symptoms. 29.7% had a history of CAD. Average number of leads extracted was 1.3 ± 0.57 compared to 2.1 ± 0.82 leads in situ. Patients with CAD had a statistically significant increased risk for extraction as a result of venous occlusion Odds Ratio of 6.80, 95% CI 2.47-18.6, p = 0.0001. Conclusions: Identification of predictors of venous occlusion and risk stratification of these patients is an important component of procedural planning and shared decision making. CAD is a predictor of venous occlusion in patients undergoing lead extraction and should be assessed as a risk factor for complex lead management decisions. Further study is warranted to identify mechanisms by which this relationship can be used to predict need for extraction due to vascular occlusion.

Abstract 4660: Death Due to Pacemaker or ICD Device Failure is Rare: Implications for the Management of Recalls

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Robert G Hauser ◽  
David L Hayes ◽  
David S Cannom ◽  
Andrew E Epstein ◽  
Stephen C Vlay ◽  
...  
Keyword(s):  
Pulse Generator ◽  
Short Circuit ◽  
High Rate ◽  
Lead Extraction ◽  
Lead Failure ◽  
Device Failure ◽  
Inappropriate Shocks ◽  
Clinical Events ◽  
Clinical Consequences ◽  
Multicenter Registry

Knowledge of major adverse clinical events (MACE) associated with ICD and pacemaker (PM) pulse generator (PG) and lead performance may be important for managing patients who have these devices. The aim of our study was to assess MACE in our Multicenter Registry. Participating centers prospectively reported ICD and PM PG and lead failures, and PG replaced for normal battery depletion (NBD). Data included dates of implant and removal, failure signs including the elective replacement indicator (ERI), clinical consequences, and reason for removal. MACE were death, inappropriate shocks (IAS), syncope, heart failure, ischemia, sustained tachyarrhythmias, and replacement of a normally functioning PG or lead due to a manufacturers recall. Since 1998, 6,291 ICD and PM PG and leads were removed from service. Of 5,212 ICD and PM PGs, 4,562 (88%) were removed for NBD, 346 (7%) for a recall, and 304 (5%) for component defects. MACE are shown in the Table . The deaths (n=2) were due to component defects causing an ICD PG to short-circuit and a PM PG to deliver high rate pacing. Thus, of the 304 component defects in our database, 2 resulted in death (0.7%). No deaths were associated with ICD or PM lead failure, but 2 deaths occurred following PM lead extraction. The ERI, signifying NBD, resulted in 48 MACE, primarily syncope (67%). Most MACE are due to replacement of normally functioning recalled devices. However, our experience suggests that death due to ICD and PM PG component or lead failure is rare; this finding may be important for managing patients who have recalled devices. Overall, MACE may be substantially reduced by improving high voltage lead reliability, and by providing physiologic ERIs.

Sign in / Sign up

Export Citation Format

Share Document