Risk of Sprint Fidelis defibrillator lead failure is highly dependent on age

Girerd, Nicolas; Nonin, Emilie; Pinot, Julien; Morel, E.; Flys, Carine; Scridon, Alina; Chevalier, Philippe

doi:10.1016/j.acvd.2011.05.002

Cited by 11 publications

(6 citation statements)

References 26 publications

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“…The survival rate of the 6949 lead model CareLink PLUS cohort is lower for longer implant durations, younger patients, patients with a single-chamber device, and female patients, as illustrated in the figures in Online Supplementary Material 2. A number of single and multicenter studies have also reported female sex 4,5 and younger patients [6][7][8] as predictors of higher lead failure hazard. The reason for the higher risk for female patients is currently unknown.…”

Section: Discussionmentioning

confidence: 99%

Impact of generator replacement on the risk of Fidelis lead fracture

et al. 2016

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The Fidelis lead survival rate after generator replacement does not differ from that of the Fidelis leads that have not had replacement. In the event of generator replacement with no manifestation of lead fracture, the lead model, patient age and life expectancy, ejection fraction, comorbidities, ease of extraction, local extraction expertise, and patient preference should be considered to determine the best course of action.

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Section: Discussionmentioning

confidence: 99%

Impact of generator replacement on the risk of Fidelis lead fracture

et al. 2016

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“…Girerd et al [38], among 269 SF leads, observed 33 (12.3%) lead failures with five-year survival of 65.6 ± 7.5%; age was indicated as single predictor of lead damage. Patients with median age < 62.5 years had significantly higher risk of lead failure, and the annual incidence of lead failure was 11.6 ± 4.9% during the fourth year and 22.9 ± 13.2% during the fifth year after implantation [38]. The estimated five-year lead survival was low and few other reports showed that the risk of SF continuously decreased with time [39,40].…”

Section: Medtronic Lead Managementmentioning

confidence: 95%

“…The risk in patients with lead removal was 19.8% vs. 8.6% when compared to those with abandoned leads. However, Girerd et al [38] indicated that sufficient data supporting the fact that lead failure is more common in young patients led to the conviction that prophylactic a new lead placement at the time of generator replacement should be recommended. Nonetheless, other studies should determine if damaged leads should be abandoned or explanted.…”

Section: Medtronic Lead Managementmentioning

confidence: 99%

Lead insulation failure, a serious complication: risk factors and management

Kołodzińska

Kutarski

2015

Kardiol Pol

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We may divide abrasions according to mechanism into "outside-in" and "inside-out" abrasions. The "outside-in" abrasions are well known in the pocket as the result of friction between leads or between the lead and the device, as well as in the venous system, with tearing surfaces among leads, first rib, and clavicle. However, "outside-in" abrasions most frequently appear in the intracardiac part of the lead and are associated with infective endocarditis (IE) [2]. The outer insulation abrasion remains electrically signless unless concomitant inner insulation failure occurs and in the device control both oversensing and undersensing may be observed [3]. The Banacha classification was established to morphologically describe abrasions analysed with an optical microscope, and to facilitate comparison and analysis. The classification distinguishes three levels of silicone in vivo damage: mild, moderate, and severe, all in two subtypes: a and b [2]. A severe abrasion with conductor exposure may be assessed clinically (Fig. 1A) [4]. Insulation abrasion more often concerned patients with sub-pectorally or abdominally implanted devices. Risk factors of intracardiac abrasions are implantation of two or more leads in the heart cavities, and in the case of atrial leads: passive fixation, longer mean dwell time (time from implantation), and three or more procedures proceeding lead extraction [2]. Severe abrasions with conductor exposure were associated with the number of extracted leads, dwell time, location of the lead in the coronary sinus, and excessive lead length in the cardiac chambers [4]. The most important observation was that, irrespective of the abrasion level of degradation in the intracardiac part of the lead, they were associated with IE development [2]. The process of outside-in abrasion may be

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“…15 Risk of Sprint Fidelis defibrillator lead failure is significantly higher in patients ,62.5 years, and the majority of our patients were in this age category. 16 The high adverse event rates may also reflect referral bias as all of the centres in the study are tertiary referral centres, and CS patients may have been referred for management of lead complication or device infection. One patient in this study, previously reported in a case report by Schuller et al, 17 had fluctuations in ventricular sensing due to loss of R-wave voltage resulting from inflammation related to CS.…”

Section: Adverse Events In Patients With Cardiac Sarcoidosis Receivinmentioning

confidence: 99%