{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T09:04:36Z","timestamp":1764493476949},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2003,2,7]],"date-time":"2003-02-07T00:00:00Z","timestamp":1044576000000},"content-version":"vor","delay-in-days":37,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2003,1]]},"abstract":"<jats:p> <jats:bold>Implantable Defibrillator Lead Failure. <jats:italic>Introduction:<\/jats:italic> Patients with implantable cardioverter defibrillators (ICD) critically depend on correct functioning of their system. The aim of this study was to determine the incidence and clinical presentation of transvenous ICD lead failures during long\u2010term follow\u2010up.<\/jats:bold> <\/jats:p><jats:p> <jats:bold>\n            <jats:italic>Methods and Results:<\/jats:italic> The study group consisted of 261 consecutive patients who received Medtronic right ventricular polyurethane transvenous leads (models 6884, 6966, 6936) between 1990 and 1998 as part of an abdominal<\/jats:bold>\n          <jats:styled-content>\n              <jats:bold>(n = 70)<\/jats:bold>\n            <\/jats:styled-content>\n          <jats:bold>or pectoral<\/jats:bold>\n          <jats:styled-content>\n              <jats:bold>(n = 191)<\/jats:bold>\n            <\/jats:styled-content>\n          <jats:bold>ICD system. During mean follow\u2010up of<\/jats:bold>\n          <jats:styled-content>\n              <jats:bold>4.0 \u00b1 2.6 years<\/jats:bold>\n            <\/jats:styled-content>\n          <jats:bold>, 31 patients (12%) developed a lead\u2010related sensing failure with oversensing of artifacts. All failures except two were compatible with an insulation defect and occurred late after ICD placement (<\/jats:bold>\n          <jats:styled-content>\n              <jats:bold>6.0 \u00b1 1.8 years<\/jats:bold>\n            <\/jats:styled-content>\n          <jats:bold>after implant). Lead survival decreased from 98% at 4\u2010year follow\u2010up to only 62% at 8\u2010year follow\u2010up. Lead survival was not related to patient age, sex, venous lead implantation route, or device implantation site. In 26 (87%) of 31 patients, a sensing defect resulted in inappropriate detection of ventricular fibrillation and subsequent delivery of<\/jats:bold>\n          <jats:styled-content>\n              <jats:bold>3 \u00b1 3<\/jats:bold>\n            <\/jats:styled-content>\n          <jats:bold>(range 1\u201311) inappropriate shocks in 19 (61%) of 31 patients. Device interrogation showed artifacts classified as nonsustained ventricular tachycardia in 21 patients,<\/jats:bold>\n          <jats:styled-content>\n              <jats:bold>40 \u00b1 43 days<\/jats:bold>\n            <\/jats:styled-content>\n          <jats:bold>before clinically relevant failure of the system. One patient with a subclavian crush syndrome required resuscitation because of undersensing of true ventricular fibrillation.<\/jats:bold> <\/jats:p><jats:p> <jats:bold>\n            <jats:italic>Conclusion:<\/jats:italic> Transvenous polyurethane ICD leads showed a high rate of lead insulation failure late after implantation with frequent inappropriate shock deliveries. Close follow\u2010up is mandatory in patients with these leads. Automated device control features with patient alert function integrated into new devices may contribute to early detection of lead failure.<\/jats:bold> <\/jats:p>","DOI":"10.1046\/j.1540-8167.2003.02305.x","type":"journal-article","created":{"date-parts":[[2003,3,12]],"date-time":"2003-03-12T04:22:21Z","timestamp":1047442941000},"page":"38-43","source":"Crossref","is-referenced-by-count":119,"title":["Transvenous Defibrillation Leads: High Incidence of Failure During Long\u2010Term 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