Abstract
Pacemaker and ICD leads have complex compound designs and are therefore the weakest link in cardiac rhythm device therapy. Technical problems are mostly insulation defects. Their number increases during follow-up and makes up more than 50 percent of the yearly failure rate of up to 20% after ten years of service life. Design flaws of specific lead models need special management. The implanting physician is first confronted with anatomic barriers to lead introduction, but his technique also impacts the hardware's failure rate, and his training and procedure volume are predictive of the dislodgment risk, the need for revision and, eventually, infection. Every potential hardware contamination urges complete removal of the system. Early explantation improves prognosis. First choice is transvenous lead extraction which achieves high success rates even with left heart leads but also has specific risks of complications.
Literatur
-
1 Benditt D G. Leadless pacing: Is it realistic?. ESC Stockholm; 2010
-
2
Bardy G H, Smith W M, Hood M A et al.
An entirely subcutaneous implantable cardioverter-defibrillator.
N Engl J Med.
2010;
363
36-44
-
3 Frey B. Transvenöse Pace-Sense-Sonden bei Patienten mit implantierbarem Kardioverter-Defibrillator: Häufigkeit von Sondendefekten im Langzeitverlauf. [Dissertation] München; 2006
-
4
Phillips R, Frey M, Martin R O.
Long-term performance of polyurethane pacing leads: mechanisms of design-related failures.
Pacing Clin Electrophysiol.
1986;
9
166-1172
-
5
Stokes K, Urbanski P, Upton J.
The in vivo auto-oxidation of polyether polyurethane by metal ions.
J Biomater Sci Polym Ed.
1990;
1
207-230
-
6
Jenney C, Tan J, Karicherla A.
A new insulation material for cardiac leads with potential for improved performance.
Heart Rhythm.
2006;
2
318-319
-
7 Aqua Institut GmbH .Bundesauswertung zum Verfahrensjahr 2010 : 09/4 Implantierbare Defibrillatoren – Implantation. Göttingen; 2011
-
8
Neuzner J, Carlsson J.
Dual- versus single-coil implantable defibrillator leads: Review of the literature.
Clin Res Cardiol.
2012;
[in press]
-
9
Di CA , Bongiorni M G, Zucchelli G et al.
Transvenous extraction performance of expanded polytetrafluoroethylene covered ICD leads in comparison to traditional ICD leads in humans.
Pacing Clin Electrophysiol.
2010;
33
1376-1381
-
10
Hackler J W, Sun Z, Lindsay B D et al.
Effectiveness of implantable cardioverter-defibrillator lead coil treatments in facilitating ease of extraction.
Heart Rhythm.
2010;
7
890-897
-
11
Ratliff H L, Yousufuddin M, Lieving W R et al.
Persistent left superior vena cava: case reports and clinical implications.
Int J Cardiol.
2006;
113
242-246
-
12
Kropil P, Lanzman R S, Miese F R et al.
Minimally invasive catheter procedures to assist complicated pacemaker lead extraction and implantation in the operating room.
Cardiovasc Intervent Radiol.
2011;
34
345-351
-
13
Kirkfeldt R E, Johansen J B, Nohr E A et al.
Risk factors for lead complications in cardiac pacing: a population-based cohort study of 28,860 Danish patients.
Heart Rhythm.
2011;
8
1622-1628
-
14 Aqua Institut GmbH .Bundesauswertung zum Verfahrensjahr 2010 : 09/1 – Herzschrittmacher-Erstimplantation. Göttingen; 2011
-
15 Aqua Institut GmbH .Bundesauswertung zum Verfahrensjahr 2010 : 09/3 – Herzschrittmacher-Revision/-Systemwechsel/-Explantation. Göttingen; 2011
-
16
Lee D S, Krahn A D, Healey J S et al.
Evaluation of early complications related to De Novo cardioverter defibrillator implantation insights from the Ontario ICD database.
J Am Coll Cardiol.
2010;
55
774-782
-
17
vanRees J B, de Bie M K, Thijssen J et al.
Implantation-related complications of implantable cardioverter-defibrillators and cardiac resynchronization therapy devices: a systematic review of randomized clinical trials.
J Am Coll Cardiol.
2011;
58
995-1000
-
18
Cheng A, Wang Y, Curtis J P, Varosy P D.
Acute lead dislodgements and in-hospital mortality in patients enrolled in the national cardiovascular data registry implantable cardioverter defibrillator registry.
J Am Coll Cardiol.
2010;
56
1651-1656
-
19 Aqua Institut GmbH .Bundesauswertung zum Verfahrensjahr 2010 : 09/6 – Implantierbare Defibrillatoren-Revision/-Systemwechsel/-Explantation. Göttingen; 2011
-
20
Rordorf R, Canevese F, Vicentini A et al.
Delayed ICD lead cardiac perforation: comparison of small versus standard-diameter leads implanted in a single center.
Pacing Clin Electrophysiol.
2011;
34
475-483
-
21
Hauser R G, Hayes D L, Kallinen L M et al.
Clinical experience with pacemaker pulse generators and transvenous leads: an 8-year prospective multicenter study.
Heart Rhythm.
2007;
4
154-160
-
22
Kleemann T, Becker T, Doenges K et al.
Annual rate of transvenous defibrillation lead defects in implantable cardioverter-defibrillators over a period of > 10 years.
Circulation.
2007;
115
2474-2480
-
23
Hauser R G, Maisel W H, Friedman P A et al.
Longevity of Sprint Fidelis implantable cardioverter-defibrillator leads and risk factors for failure: implications for patient management.
Circulation.
2011;
123
358-363
-
24
Hauser R G, Hayes D L.
Increasing hazard of Sprint Fidelis implantable cardioverter-defibrillator lead failure.
Heart Rhythm.
2009;
6
605-610
-
25
Kallinen L M, Hauser R G, Tang C et al.
Lead integrity alert algorithm decreases inappropriate shocks in patients who have Sprint Fidelis pace-sense conductor fractures.
Heart Rhythm.
2010;
7
1048-1055
-
26
Priori S G, Auricchio A, Nisam S, Yong P.
To replace or not to replace: a systematic approach to respond to device advisories.
J Cardiovasc Electrophysiol.
2009;
20
164-170
-
27
Kay G N, Brinker J A, Kawanishi D T et al.
Risks of spontaneous injury and extraction of an active fixation pacemaker lead: report of the Accufix Multicenter Clinical Study and Worldwide Registry.
Circulation.
1999;
100
2344-2352
-
28
Schulte B, Carlsson J, Neuzner J.
Electrical interference between two transvenous implantable defibrillator leads.
Heart.
2001;
86
14
-
29
Pfitzner P, Trappe H J.
Oversensing in a cardioverter defibrillator system caused by interaction between two endocardial defibrillation leads in the right ventricle.
Pacing Clin Electrophysiol.
1998;
21
764-768
-
30
Lee J C, Epstein L M, Huffer L L et al.
ICD lead proarrhythmia cured by lead extraction.
Heart Rhythm.
2009;
6
613-618
-
31
Bracke F A, Meijer A, van Gelder L M.
Malfunction of endocardial defibrillator leads and lead extraction: where do they meet?.
Europace.
2002;
4
19-24
-
32
Amelot M, Foucault A, Scanu P et al.
Comparison of outcomes in patients with abandoned versus extracted implantable cardioverter defibrillator leads.
Arch Cardiovasc Dis.
2011;
104
572-577
-
33
Suga C, Hayes D L, Hyberger L K et al.
Is there an adverse outcome from abandoned pacing leads?.
J Interv Card Electrophysiol.
2000;
4
493-499
-
34
Wollmann C G, Bocker D, Loher A et al.
Two different therapeutic strategies in ICD lead defects: additional combined lead versus replacement of the lead.
J Cardiovasc Electrophysiol.
2007;
18
1172-1177
-
35
de Cock C C, Vinkers M, van Campe L C et al.
Long-term outcome of patients with multiple (> or = 3) noninfected transvenous leads: a clinical and echocardiographic study.
Pacing Clin Electrophysiol.
2000;
23
423-426
-
36
Lin G, Nishimura R A, Connolly H M et al.
Severe symptomatic tricuspid valve regurgitation due to permanent pacemaker or implantable cardioverter-defibrillator leads.
J Am Coll Cardiol.
2005;
45
1672-1675
-
37
Wollmann C G, Bocker D, Loher A et al.
Incidence of complications in patients with implantable cardioverter/defibrillator who receive additional transvenous pace/sense leads.
Pacing Clin Electrophysiol.
2005;
28
795-800
-
38
Jacobs D M, Fink A S, Miller R P et al.
Anatomical and morphological evaluation of pacemaker lead compression.
Pacing Clin Electrophysiol.
1993;
16
434-444
-
39
Al-Khatib S M, Greiner M A, Peterson E D et al.
Patient and implanting physician factors associated with mortality and complications after implantable cardioverter-defibrillator implantation, 2002–2005.
Circ Arrhythm Electrophysiol.
2008;
1
240-249
-
40
Harcombe A A, Newell S A, Ludman P F et al.
Late complications following permanent pacemaker implantation or elective unit replacement.
Heart.
1998;
80
240-244
-
41
Krahn A D, Lee D S, Birnie D et al.
Predictors of short-term complications after implantable cardioverter-defibrillator replacement: results from the Ontario ICD Database.
Circ Arrhythm Electrophysiol.
2011;
4
136-142
-
42
Al-Khatib S M, Lucas F L, Jollis J G et al.
The relation between patients' outcomes and the volume of cardioverter-defibrillator implantation procedures performed by physicians treating Medicare beneficiaries.
J Am Coll Cardiol.
2005;
46
1536-1540
-
43
Johansen J B, Jorgensen O D, Moller M et al.
Infection after pacemaker implantation: infection rates and risk factors associated with infection in a population-based cohort study of 46.299 consecutive patients.
Eur Heart J.
2011;
32
991-998
-
44
da Costa A, Kirkorian G, Cucherat M et al.
Antibiotic prophylaxis for permanent pacemaker implantation: a meta-analysis.
Circulation.
1998;
97
1796-1801
-
45
de Oliveira J C, Martinelli M, Nishioka S A et al.
Efficacy of antibiotic prophylaxis before the implantation of pacemakers and cardioverter-defibrillators: results of a large, prospective, randomized, double-blinded, placebo-controlled trial.
Circ Arrhythm Electrophysiol.
2009;
2
29-34
-
46
Klug D, Balde M, Pavin D et al.
Risk factors related to infections of implanted pacemakers and cardioverter-defibrillators: results of a large prospective study.
Circulation.
2007;
116
1349-1355
-
47
Le K Y, Sohail M R, Friedman P A et al.
Clinical predictors of cardiovascular implantable electronic device-related infective endocarditis.
Pacing Clin Electrophysiol.
2011;
34
450-459
-
48
de Bie M K, van Rees J B, Thijssen J et al.
Cardiac Device Infections are associated with a significant mortality risk.
Heart Rhythm.
2011;
[in press]
-
49
Hemmer W, Fröhlig G, Markewitz A.
Kommentar zu den NASPE-Empfehlungen zur Entfernung von permanent implantierten, transvenösen Herzschrittmacher- und Defibrillatorsonden.
Z Kardiol.
2002;
91
956-968
-
50
Wilkoff B L, Love C J, Byrd C L et al.
Transvenous lead extraction: Heart Rhythm Society expert consensus on facilities, training, indications, and patient management: this document was endorsed by the American Heart Association (AHA).
Heart Rhythm.
2009;
6
085-1104
-
51
Le K Y, Sohail M R, Friedman P A et al.
Impact of timing of device removal on mortality in patients with cardiovascular implantable electronic device infections.
Heart Rhythm.
2011;
8
1678-1685
-
52
Williams S E, Arujuna A, Whitaker J et al.
Percutaneous Lead and System Extraction in Patients with Cardiac Resynchronization Therapy (CRT) Devices and Coronary Sinus Leads.
Pacing Clin Electrophysiol.
2011;
34
1209-1216
-
53
Calton R, Cameron D, Cusimano R J et al.
Successful laser-assisted removal of an infected ICD lead with a large vegetation.
Pacing Clin Electrophysiol.
2006;
29
910-913
-
54
Sohail M R, Uslan D Z, Khan A H et al.
Infective endocarditis complicating permanent pacemaker and implantable cardioverter-defibrillator infection.
Mayo Clin Proc.
2008;
83
46-53
-
55
Mugge A, Gulba D C, Jost S et al.
Dissolution of a right atrial thrombus attached to pacemaker electrodes: usefulness of recombinant tissue-type plasminogen activator.
Am Heart J.
1990;
119
1437-1439
-
56
Cooper C J, Dweik R, Gabbay S.
Treatment of pacemaker-associated right atrial thrombus with 2-hour rTPA infusion.
Am Heart J.
1993;
126
228-229
-
57
Chuang S, Mehta R H, Fay W P.
Prolonged low-dose thrombolytic therapy: a novel adjunctive strategy in the management of an infected right atrial thrombus.
Clin Cardiol.
2002;
25
346-349
-
58
Bongiorni M G, Soldati E, Zucchelli G et al.
Transvenous removal of pacing and implantable cardiac defibrillating leads using single sheath mechanical dilatation and multiple venous approaches: high success rate and safety in more than 2000 leads.
Eur Heart J.
2008;
29
2886-2893
-
59
Kennergren C, Bjurman C, Wiklund R et al.
A single-centre experience of over one thousand lead extractions.
Europace.
2009;
11
612-617
-
60
Wazni O, Epstein L M, Carrillo R G et al.
Lead extraction in the contemporary setting: the LExICon study: an observational retrospective study of consecutive laser lead extractions.
J Am Coll Cardiol.
2010;
55
579-586
-
61
Klug D, Wallet F, Lacroix D et al.
Local symptoms at the site of pacemaker implantation indicate latent systemic infection.
Heart.
2004;
90
882-886
Prof. Dr. med. G. Fröhlig
Kraftwerkstraße 24
66424 Homburg
Email: ingfro@kabelmail.de
