
Clinical and radiographic predictors of cardiovascular implantable electronic device lead failure at the time of initial implantation
Author(s) -
Kim Eunjeong,
Davogustto Giovanni,
Huang Shi,
Crossley George H.,
Montgomery Jay A.
Publication year - 2021
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1002/joa3.12559
Subject(s) - medicine , lead (geology) , defibrillation , implant , heart failure , cardiac resynchronization therapy , odds ratio , implantable cardioverter defibrillator , implantation failure , implant failure , radiography , cardiology , ejection fraction , surgery , infertility , pregnancy , geomorphology , biology , genetics , geology
Objective To assess the clinical and radiographic factors associated with lead failure by comparing subjects with lead failure within 10 years of implantation with an implant‐year‐matched group without lead failure. Methods A case‐control study with 49 subjects who received Cardiac Implantable Electronic Device (CIED) between January 1, 1999 and July 31, 2008 and developed lead failure within 10 years of implantation in a single center. The control group consisted of subjects (n = 54) with normally functioning leads matched one‐to‐one by implant year. Results Among the failure group, the meantime from implantation to device lead failure was 4.70 ± 2.94 years. Older age at implantation was associated with a lower likelihood of lead failure (Odds Ratio (OR) = 0.28 (75 vs 42 years old), 95% CI 0.12‐0.63, P = .002). A larger smallest loop diameter on the chest radiograph was also associated with a lower likelihood of lead failure (OR = 0.51 (31 vs 14 mm), 95% CI 0.27‐0.97, P = .04). CIED type (defibrillator vs pacemaker) and Ottawa scores were not significantly associated with lead failure. Among lead‐specific parameters, defibrillation lead vs pace‐sense lead was associated with lead failure (OR = 3.91, 95% CI 1.95‐7.81, P < .001). Conclusions Younger age, defibrillation leads, and small lead loops are associated with lead failure in CIEDs. Techniques to avoid tight loops in the pocket could potentially reduce the risk of lead failure and bear important implications for the implanting physician.