Performance and survival of transvenous defibrillation leads: need for a European data registry

Although the use of implantable cardioverter defibrillator (ICD) therapy has increased over the last decades, the reporting of ICD lead performance is inadequate. So far, there is neither a European nor worldwide registry on ICD leads. The published long-term results from national or multicentre registries encompass relatively small patient cohorts. Nevertheless, the failure of ICD leads may have substantial clinical consequences, including failure to sense, failure to pace, failure to defibrillate, inappropriate shocks, and even death of the patient. The reported ICD lead survival varies significantly between studies: 91-99% at 2 years, 85-95% at 5 years, and 60-72% at 8 years. Thus, the true incidence of lead malfunction cannot be defined as outlined in the present review. One current initiative of the European Heart Rhythm Association is to initiate and develop a Europe-wide registry to monitor, over a prolonged follow-up period, the performance of ICDs and ICD leads.