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Titolo:
HIGH FAILURE RATE FOR AN EPICARDIAL IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR LEAD - IMPLICATIONS FOR LONG-TERM FOLLOW-UP OF PATIENTS WITH AN IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR
Autore:
BRADY PA; FRIEDMAN PA; TRUSTY JM; GRICE S; HAMMILL SC; STANTON MS;
Indirizzi:
MAYO CLIN & MAYO FDN,DIV CARDIOVASC DIS ROCHESTER MN 55905 MAYO CLIN & MAYO FDN,DIV CARDIOVASC DIS ROCHESTER MN 55905
Titolo Testata:
Journal of the American College of Cardiology
fascicolo: 3, volume: 31, anno: 1998,
pagine: 616 - 622
SICI:
0735-1097(1998)31:3<616:HFRFAE>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
INSULATION BREAK; SENSING LEADS; COMPLICATIONS; SYSTEMS; SHOCKS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
15
Recensione:
Indirizzi per estratti:
Citazione:
P.A. Brady et al., "HIGH FAILURE RATE FOR AN EPICARDIAL IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR LEAD - IMPLICATIONS FOR LONG-TERM FOLLOW-UP OF PATIENTS WITH AN IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR", Journal of the American College of Cardiology, 31(3), 1998, pp. 616-622

Abstract

Objectives. The purpose of this study was to determine the risk of epicardial lead failure during long-term follow-up and its mode of presentation, Background. Despite the high prevalence of epicardial lead-based implantable cardioverter-defibrillators, their long-term performance is unknown, and appropriate follow-up has not been established, Methods. The study group comprised all patients in whom an epicardial lead system was implanted at the Mayo Clinic between October 31, 1984 andNovember 3, 1994, The number of lead fractures and leads with fluid within the insulation and the made of presentation were determined retrospectively by review of patient visits, radiographs of lead systems and data derived from formal lead testing. Results. At 4 years, the survival rate free of lead malfunction, using formal lead testing, for 160 Medtronic epicardial patches (models 6897 and 6921) was 72% comparedwith 92.5% for the 179 Cardiac Pacemaker, Inc. (CPI) patches (models 0040 and 0041) (p = = 0.01). In addition, five Medtronic patches in three patients had fluid within the lead insulation but no obvious fracture, No CPI patches had fluid identified within the leads. Of 330 Medtronic epicardial pace/sense leads (model 6917), the 4-year survival rate Free of lead malfunction as assessed by lead testing was 94%. In all, 18 presentations of lead malfunction were found in 17 patients (2 patients had more than one lead fracture at different times). In 11 (58%) of these presentations, the patients were asymptomatic despite the presence of obvious lead fracture. Conclusions. Epicardial lead malfunction is common on long-term follow-up, and some leads have a failure rate of 28% at 4 years. Many patients with fractured leads remain asymptomatic, despite involvement of multiple leads in some casts, Therefore, consideration should be given to regular periodic lead testing in addition to routine X-ray examination, as as symptomatic lead malfunction can present with normal chest X-ray findings. (C) 1998 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 08:24:53