{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:51:16Z","timestamp":1760244676041,"version":"build-2065373602"},"reference-count":18,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T00:00:00Z","timestamp":1669680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: In the last decade, newer generation ICD leads have been developed based on mechanistic insides of priorly failing leads. The aim of our study was to assess the long-term performance and mechanisms of failure of the 2013-introduced Biotronik Protego ICD lead in a real-world population. Methods: All patients, who underwent implantation of a Protego ICD lead at the Heart Centre Lucerne (Lucerne, Switzerland) between November 2013 and March 2017, were followed up with semi-annual device-controls. The primary endpoint was defined as lead failure, secondary endpoints compromised all-cause death, (in)appropriate shocks and the need for reintervention. Results: A total of 64 patients (mean age 66.7 \u00b1 8.7 years, 30% female) underwent implantation of a Protego ICD lead: 78% for primary prevention, 53% had underlying ischemic heart disease, and 40.6% had a dilated cardiomyopathy (DCM). Mean left ventricular ejection fraction (LVEF) was 32.6 \u00b1 10.5%. A total of 24 patients were treated with cardiac resynchronization therapy (CRT), and their baseline LVEF improved from 27.8 \u00b1 7.3% before to 39.8 \u00b1 12.5 after implantation (p &lt; 0.001). Mean time to follow-up was 5.5 \u00b1 0.9 years. Overall, 14 patients (26.6%) suffered from at least one episode of sustained ventricular tachycardia; in total 10 patients (15.6%) died. Two patients experienced lead failure due to lead fracture after 5.5 and 5.7 years, which was clinically apparent by an abrupt rise in lead impedance (&gt;2000 \u03a9) and by repetitive inappropriate shocks, respectively. Conclusions: In this retrospective observational study, the calculated annual lead failure rate of the Biotronik Protego ICD lead was 0.59% per patient\u2014thus, the durability and long-term performance seem to be promising.<\/jats:p>","DOI":"10.3390\/jcm11237070","type":"journal-article","created":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T07:10:27Z","timestamp":1669792227000},"page":"7070","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Experience with the Biotronik Protego ICD Lead"],"prefix":"10.3390","volume":"11","author":[{"given":"Thomas","family":"Seiler","sequence":"first","affiliation":[{"name":"Heart Centre Lucerne, Luzerner Kantonsspital, 6000 Luzern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Grebmer","sequence":"additional","affiliation":[{"name":"Heart Centre Lucerne, Luzerner Kantonsspital, 6000 Luzern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"Hilfiker","sequence":"additional","affiliation":[{"name":"Heart Centre Lucerne, Luzerner Kantonsspital, 6000 Luzern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3988-7262","authenticated-orcid":false,"given":"Richard","family":"Kobza","sequence":"additional","affiliation":[{"name":"Heart Centre Lucerne, Luzerner Kantonsspital, 6000 Luzern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Berte","sequence":"additional","affiliation":[{"name":"Heart Centre Lucerne, Luzerner Kantonsspital, 6000 Luzern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1056\/NEJMoa013474","article-title":"Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction","volume":"346","author":"Moss","year":"2002","journal-title":"N. 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