{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:25:55Z","timestamp":1792725955135,"version":"4.5.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,5,15]]},"abstract":"\n Background<\/jats:title>\n \n The transvenous implantable cardioverter\u2010defibrillator (\n ICD<\/jats:styled-content>\n ) lead is the most common source of complications in a traditional\n ICD<\/jats:styled-content>\n system. This investigation aims to determine the incidence, predictors, and costs associated with these complications using a large insurance database.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Data from the OptumLabs\u2122 Data Warehouse, which include diagnosis, physician and procedure codes, and claims from patient hospitalizations, were analyzed. Patients with a de novo\n ICD<\/jats:styled-content>\n or cardiac resynchronization therapy defibrillator implanted from January 1, 2003, through June 30, 2015, were included; those who did not have continuous coverage beginning 1\u00a0year before implantation were excluded, resulting in 40\u00a0837 patients followed up over an average of 2.3\u00b12.1\u00a0years. Patients were followed up until they had the procedure or their last active date in the database. Of 20\u00a0580 device procedures, 2165 (5.3%) and 771 (1.9%) had mechanical and infectious complications, respectively. The 5\u2010year rate of freedom from mechanical complication was 92.0% and 89.3% for\n ICD<\/jats:styled-content>\n s and cardiac resynchronization therapy defibrillators, respectively. Infectious complications were more likely in patients with a history of atrial fibrillation, diabetes mellitus, and renal disease, and the risk increased with subsequent device procedures. Younger age, female sex, lack of comorbidities, and implantations between 2003 and 2008 were associated with more mechanical complications.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Incidence of mechanical and infectious complications of transvenous\n ICD<\/jats:styled-content>\n leads over long\u2010term follow\u2010up is much higher in the real world than in clinical studies. In our study cohort, 1 of 4 transvenous\n ICD<\/jats:styled-content>\n leads had mechanical complications when followed up to 10\u00a0years. The high rate of reintervention leads to additional complications.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.007691","type":"journal-article","created":{"date-parts":[[2018,5,10]],"date-time":"2018-05-10T09:20:15Z","timestamp":1525944015000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":103,"title":["Risk Factors and Temporal Trends of Complications Associated With Transvenous Implantable Cardiac Defibrillator Leads"],"prefix":"10.1161","volume":"7","author":[{"given":"Jayanthi N.","family":"Koneru","sequence":"first","affiliation":[{"name":"VCU School of Medicine, Medical College of Virginia Hospitals, Richmond, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul W.","family":"Jones","sequence":"additional","affiliation":[{"name":"Boston Scientific, Marlborough, MA"},{"name":"OptumLabs, Cambridge, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric F.","family":"Hammill","sequence":"additional","affiliation":[{"name":"Boston Scientific, Marlborough, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Wold","sequence":"additional","affiliation":[{"name":"Boston Scientific, Marlborough, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth A.","family":"Ellenbogen","sequence":"additional","affiliation":[{"name":"VCU School of Medicine, Medical College of Virginia Hospitals, Richmond, VA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199612263352601"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043399"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.01.035"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.2782"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.698597"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.663807"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2014-000198"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2014.0038"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.8462"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002418"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.108.834093"},{"key":"e_1_3_4_15_2","unstructured":"Medtronic . 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