Survival of transvenous ICD leads in young patients

William J. Bonney, Henry M. Spotnitz, Leonardo Liberman, Eric S. Silver, Scott R. Ceresnak, Allan J. Hordof, Robert H. Pass

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: In adults, transvenous implantable cardioverter defibrillator (ICD) lead failure rates are significant, and their occurrence increases with time from implant. There are limited data in children. The goal of this study was to assess lead survival in young patients undergoing ICD implantation at a single center. Methods: Records of patients under 21 years old with transvenous ICD leads implanted at our center from June 1997 to August 2007 were retrospectively reviewed. Age, weight, height, diagnosis, lead and generator model, venous access technique, generator position, pacing thresholds, lead impedance, and R wave size were recorded. "Lead failure" was defined as any lead problem requiring surgical intervention to restore proper function to the ICD system. Results: Seventy-one transvenous leads were included (70 patients). Average age at implant was 14.8 years (range 5.7-19.5). All the devices were implanted by a single operator (HMS). Venous access was obtained via cephalic cutdown in 66/71. Mean follow-up time was 2.8 years (range 0.2-7.8 years, median 2.3 years). There were no infections requiring explantation. There were four lead failures. Three were lead fractures, occurring 12, 13, and 19 months after implant. The fourth lead failed when an arrhythmia was not appropriately detected, and a second dedicated rate-sensing lead was thus implanted. Univariate analysis did not identify any variable to be a significant predictor of lead failure. Kaplan-Meier survival analysis demonstrated 5-year lead survival at 89.6%. Conclusions: ICD lead survival in children, when performed by an experienced operator, is similar to that found in adults.

Original languageEnglish (US)
Pages (from-to)186-191
Number of pages6
JournalPACE - Pacing and Clinical Electrophysiology
Volume33
Issue number2
DOIs
StatePublished - Feb 2010

Fingerprint

Implantable Defibrillators
Survival
Lead
Kaplan-Meier Estimate
Survival Analysis
Electric Impedance
Cardiac Arrhythmias
Head
Weights and Measures
Equipment and Supplies
Infection

Keywords

  • Defibrillation-ICD
  • Electrophysiology-clinical
  • ICD lead
  • Pediatrics
  • Sprint fidelis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Bonney, W. J., Spotnitz, H. M., Liberman, L., Silver, E. S., Ceresnak, S. R., Hordof, A. J., & Pass, R. H. (2010). Survival of transvenous ICD leads in young patients. PACE - Pacing and Clinical Electrophysiology, 33(2), 186-191. https://doi.org/10.1111/j.1540-8159.2009.02600.x

Survival of transvenous ICD leads in young patients. / Bonney, William J.; Spotnitz, Henry M.; Liberman, Leonardo; Silver, Eric S.; Ceresnak, Scott R.; Hordof, Allan J.; Pass, Robert H.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 33, No. 2, 02.2010, p. 186-191.

Research output: Contribution to journalArticle

Bonney, WJ, Spotnitz, HM, Liberman, L, Silver, ES, Ceresnak, SR, Hordof, AJ & Pass, RH 2010, 'Survival of transvenous ICD leads in young patients', PACE - Pacing and Clinical Electrophysiology, vol. 33, no. 2, pp. 186-191. https://doi.org/10.1111/j.1540-8159.2009.02600.x
Bonney WJ, Spotnitz HM, Liberman L, Silver ES, Ceresnak SR, Hordof AJ et al. Survival of transvenous ICD leads in young patients. PACE - Pacing and Clinical Electrophysiology. 2010 Feb;33(2):186-191. https://doi.org/10.1111/j.1540-8159.2009.02600.x
Bonney, William J. ; Spotnitz, Henry M. ; Liberman, Leonardo ; Silver, Eric S. ; Ceresnak, Scott R. ; Hordof, Allan J. ; Pass, Robert H. / Survival of transvenous ICD leads in young patients. In: PACE - Pacing and Clinical Electrophysiology. 2010 ; Vol. 33, No. 2. pp. 186-191.
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