{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T09:01:58Z","timestamp":1793437318965,"version":"4.5.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2011,6,7]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Long-term data on device-related untoward events in patients receiving defibrillators for resynchronization therapy (CRT-D) are lacking. We quantified the frequency of repeat invasive procedures and the nature of long-term complications in current clinical practice and examined possible predictors of device-related events and their association with long-term patient outcome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We analyzed data from 3253 patients who underwent de novo successful implantation of CRT-D and were followed up for a median of 18 months (25th to 75th percentiles: 9 to 30) in 117 Italian centers. Device-related events were reported in 416 patients, and, specifically, surgical interventions for system revision were described in 390 patients. Four years after the implantation procedure, 50% of patients underwent surgical revision for battery depletion and 14% for unanticipated events. For comparison, at 4 years battery depletion occurred in 10% and 13% of patients who received single- and dual-chamber defibrillators at the study centers, and unanticipated events were reported as 4% and 9%, respectively. In CRT-D, infections occurred at a rate of 1.0%\/y, and the risk of infections increased after device replacement procedures (hazard ratio, 2.04; 95% confidence interval, 1.01 to 4.09;\n              <jats:italic>P<\/jats:italic>\n              =0.045). Left ventricular lead dislodgements were reported at a rate of 2.3%\/y and were predicted by longer fluoroscopy time and higher pacing threshold on implantation. Device-related events were not associated with a worse clinical outcome; indeed, the risk of death was similar in patients with and without surgical revision (hazard ratio, 0.90; 95% confidence interval, 0.56 to 1.47;\n              <jats:italic>P<\/jats:italic>\n              =0.682).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In current clinical practice device-related events are more frequent in CRT-D than in single- or dual-chamber defibrillators, and are frequently managed by surgical intervention for system revision. However, a worse clinical outcome is not associated with these events.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT01007474.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.110.015024","type":"journal-article","created":{"date-parts":[[2011,5,17]],"date-time":"2011-05-17T05:12:11Z","timestamp":1305609131000},"page":"2526-2535","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":79,"title":["Long-Term Complications Related to Biventricular Defibrillator Implantation"],"prefix":"10.1161","volume":"123","author":[{"given":"Maurizio","family":"Landolina","sequence":"first","affiliation":[{"name":"From the Fondazione Policlinico S. Matteo IRCCS, Pavia (M. Landolina); IRCCS Istituto Clinico Humanitas, Rozzano, Milan (M.G.); Niguarda Hospital, Milan (M. Lunati); Villa S. Anna, Catanzaro (S.I.); University of Bologna and Azienda Ospedaliera S. Orsola-Malpighi, Bologna (G.B.); San Bortolo Hospital, Vicenza (C.B.); A.S. Ospedaliera S. Croce e Carle, Cuneo (A.V.); S. Maria della Misericordia Hospital, Udine (A.P.); Universit\u00e0 Politecnica delle Marche, Ancona (A.C.); Medtronic Italia, Rome (C.Z., S..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Gasparini","sequence":"additional","affiliation":[{"name":"From the Fondazione Policlinico S. Matteo IRCCS, Pavia (M. Landolina); IRCCS Istituto Clinico Humanitas, Rozzano, Milan (M.G.); Niguarda Hospital, Milan (M. Lunati); Villa S. Anna, Catanzaro (S.I.); University of Bologna and Azienda Ospedaliera S. Orsola-Malpighi, Bologna (G.B.); San Bortolo Hospital, Vicenza (C.B.); A.S. Ospedaliera S. Croce e Carle, Cuneo (A.V.); S. Maria della Misericordia Hospital, Udine (A.P.); Universit\u00e0 Politecnica delle Marche, Ancona (A.C.); Medtronic Italia, Rome (C.Z., S..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Lunati","sequence":"additional","affiliation":[{"name":"From the Fondazione Policlinico S. Matteo IRCCS, Pavia (M. Landolina); IRCCS Istituto Clinico Humanitas, Rozzano, Milan (M.G.); Niguarda Hospital, Milan (M. Lunati); Villa S. Anna, Catanzaro (S.I.); University of Bologna and Azienda Ospedaliera S. Orsola-Malpighi, Bologna (G.B.); San Bortolo Hospital, Vicenza (C.B.); A.S. Ospedaliera S. Croce e Carle, Cuneo (A.V.); S. Maria della Misericordia Hospital, Udine (A.P.); Universit\u00e0 Politecnica delle Marche, Ancona (A.C.); Medtronic Italia, Rome (C.Z., S..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saverio","family":"Iacopino","sequence":"additional","affiliation":[{"name":"From the Fondazione Policlinico S. Matteo IRCCS, Pavia (M. Landolina); IRCCS Istituto Clinico Humanitas, Rozzano, Milan (M.G.); Niguarda Hospital, Milan (M. Lunati); Villa S. Anna, Catanzaro (S.I.); University of Bologna and Azienda Ospedaliera S. Orsola-Malpighi, Bologna (G.B.); San Bortolo Hospital, Vicenza (C.B.); A.S. Ospedaliera S. Croce e Carle, Cuneo (A.V.); S. 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