Does implantation technique infl uence lead failure?

Abstract

Objective We aimed to analyse whether diff erent lead implantation techniques infl uence lead failure based on implant duration.

Methods and results Eighty-two transvenous leads were extracted due to lead failure. Median implant duration (MID) of the extracted leads was 68 months. Failed leads were retrospectively divided into 5 subgroups according to predefi ned technical procedural aspects, potentially triggering lead failure: venous approach, lead disorder in the generator pocket, sharp lead angulation, lead-lead interaction and number of leads in situ. The subgroups were correlated to the MID and compared. The MID was 81 vs 59 months in medial vs lateral venous puncture (P = 0.453). In subgroups without/with lead disorder the MID was 59 vs 107 months (P = 0.006) and 57 vs 84 months (P = 0.012) in subgroups without/with sharp lead angulation, respectively. In subgroups without/with more than 1 lead-lead interaction the MID was 59 vs 81 months (P = 0.029) and 65 vs 86 months (P = 0.128) without/with more than 2 lead-lead interactions, respectively. In subgroups without/with more than 1 lead in situ the MID was 73 vs 67 months (P = 0.453), 81 vs 27 months (P = 0.296) in subgroups without/with more than 2 leads in situ and 68 vs 77 months (P = 0.264) in subgroups without/with more than 3 leads in situ, respectively.

Conclusions Although, we were able to confi rm our hypothesis only partially, technical aspects of lead implantation technique should be kept in mind as a potential reason causing lead failure.

Key Words:

• Pacemaker
• ICD
• lead dysfunction/failure