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Klampfleitner S, Mundel M, Schinke K, Neuberger HR. Performance of an implantable cardioverter-defibrillator lead family. J Cardiovasc Electrophysiol 2023; 34:700-709. [PMID: 36640428 DOI: 10.1111/jce.15804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 12/13/2022] [Accepted: 12/29/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Lead failure is the major limitation in implantable cardioverter-defibrillator (ICD) therapy. Long-term follow-up data for Biotronik Linox ICD leads are limited. Therefore, we analyzed the performance of all these leads implanted at our institution. MATERIALS AND METHODS All Linox and Linox Smart ICD leads implanted between 2006 and 2015 were identified. Lead failure was defined as electrical dysfunction (oversensing, abnormal impedance, exit block). Lead survival was described, according to Kaplan-Meier. Associations between lead failure and specific variables were examined. p < .05 was considered significant. RESULTS We included 417 ICD leads. The median follow-up time for Linox (n = 205) was 81 months and for Linox Smart (n = 212) 75 months. During that follow-up time, 30 Linox (14.6%) and 16 Linox Smart leads (7.6%) showed a malfunction. The 5-year lead survival probability was 97.4% for Linox and 95.2% for Linox Smart (log-rank test, p = .19). The 6- and 8-year lead survival probability for Linox was 93.6% and 84.6%, and for Linox Smart 93% and 91.9%. The only factor significantly associated with lead failure was younger patient age at implantation (hazard ratio/year: 0.97, 95% CI: 0.94-0.99, p = .002). CONCLUSION This relatively large study with a long follow-up period highlights a relevant failure rate of Biotronik Linox leads. The performance of Linox versus Linox Smart ICD leads was comparable. Although we show an acceptable 5-year lead survival probability, we observed a marked drop after just 1 more year of follow-up. In an era of improving heart failure survival probability, a prolonged follow-up of ICD leads is increasingly clinically relevant.
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Affiliation(s)
- Stefanie Klampfleitner
- Sektion Kardiologie-Rhythmologie, Klinikum Traunstein, Traunstein, Germany.,Klinik für Innere Medizin III, Universitätsklinikum Homburg, Universität des Saarlandes, Saarbrücken, Saarland, Germany
| | - Markus Mundel
- Sektion Kardiologie-Rhythmologie, Klinikum Traunstein, Traunstein, Germany
| | - Karin Schinke
- Sektion Kardiologie-Rhythmologie, Klinikum Traunstein, Traunstein, Germany
| | - Hans-Ruprecht Neuberger
- Sektion Kardiologie-Rhythmologie, Klinikum Traunstein, Traunstein, Germany.,Klinik für Innere Medizin III, Universitätsklinikum Homburg, Universität des Saarlandes, Saarbrücken, Saarland, Germany
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2
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Giacopelli D, Azzolina D, Comoretto RI, Quartieri F, Rovaris G, Schillaci V, Gargaro A, Gregori D. Implantable cardioverter defibrillator lead performance: A systematic review and individual patient data Meta-analysis. Int J Cardiol 2023; 373:57-63. [PMID: 36460209 DOI: 10.1016/j.ijcard.2022.11.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/07/2022] [Accepted: 11/24/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Reliable post-approval surveillance of implantable cardioverter-defibrillator (ICD) lead performance remains a challenge. In the past, two ICD leads were recalled due to a high frequency of failures. In this meta-analysis, we sought to provide a combined estimate of failure-free rate for ICD leads by reconstructing individual patient data from published Kaplan-Meier (KM) curves and to investigate whether estimates could be influenced by the characteristics of the study. METHODS Observational studies assessing failure-free estimates of transvenous ICD leads with KM method, were identified through a systematic search up to November 2021. RESULTS Forty-four studies were eligible that included 41,870 (63.1%) non-recalled leads and 24,493 (36.9%) recalled leads. The 8-year cumulative failure-free rate was 94.1% (CI, 93.6% - 94.6%) for contemporary non-recalled leads and 81.2% (80.3% - 82.0%) for recalled leads (hazard ratio [HR], 3.15 [2.85-3.47], p < 0.001). Failure-free rate was lower in single-center studies in both the non-recalled (HR, 0.28 [0.15-0.51], p < 0.001) and recalled (HR, 0.54 [0.33-0.88], p = 0.014) group compared with multicenter studies. Similarly, estimates were significantly lower in small (i.e. extracted KM curve with <312 leads) versus large studies (HR non-recalled group, 0.54 [CI, 0.33-0.89], p = 0.015; HR recalled group, 0.62 [CI, 0.43-0.89], p = 0.009). CONCLUSIONS In this meta-analysis including >66,000 leads, we provide pooled survival curves that may play a role in generating evidence-based standards for assessing clinically acceptable failure rates for ICD leads. Lead performance was underestimated with single-center and small-sized studies; multicenter studies remain the main tool to reliably conduct post-market surveillance of ICD leads.
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Affiliation(s)
- Daniele Giacopelli
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, Padova, Italy; Clinical Unit, Biotronik Italia, Milan, Italy.
| | - Danila Azzolina
- Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy
| | | | - Fabio Quartieri
- Department of Cardiology, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | | | | | | | - Dario Gregori
- Department of Cardiac, Thoracic, Vascular Sciences & Public Health, University of Padova, Padova, Italy
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3
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Recent advances in cardiovascular stent for treatment of in-stent restenosis: Mechanisms and strategies. Chin J Chem Eng 2021. [DOI: 10.1016/j.cjche.2020.11.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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4
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Alasti M, Machado C, Mirzaee S, Healy S, Bittinger L, Adam D, Kotschet E, Krafchek J, Alison J. Long-term longevity and clinical outcomes of Linox S/SD implantable cardioverter-defibrillator leads: a single-center experience. J Interv Card Electrophysiol 2020; 61:115-121. [PMID: 32488749 DOI: 10.1007/s10840-020-00787-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/20/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Since the introduction of the Biotronik Linox S/SD leads in 2006, there have been multiple reports of premature lead failure. The purpose of this study was to investigate the longevity of the Linox S/SD leads and to identify the possible predictors of lead failure in a single tertiary implant center. METHODS We retrospectively reviewed patients who underwent implantation of Linox S/SD leads or Sorin Vigila 1CR/2CR leads (the same Linox S/SD leads marketed by Sorin) at our center. The cumulative lead survival was estimated using the Kaplan-Meier curve, and variables associated with lead failure were assessed by Cox proportional hazard model. RESULTS A total of 187 patients (154 (82%) male) underwent Linox S/SD or Vigila 1CR/2CR implantation between 2007 and 2013. During follow-up with a median time of 75 months, nine lead failures were identified (4.8%). The mean and median times from lead implantation to lead failure were 70.7 ± 21 months and 64 (45-111) months, respectively. The cumulative survival probability for the Linox S/SD at 5 years was 97.1% and at 12 years was 90.3%. Non-physiological high-rate sensing was the most common type of lead failure in patients. In two-thirds of these patients, this led to inappropriate shock. We did not find any significant relationships between patients' clinical and procedural characteristics and lead failure. CONCLUSIONS At our center, the 5-year lead survival of the Linox S/SD has been better than reports from other centers. The majority of lead failures presented as non-physiological high-rate sensing with subsequent inappropriate therapy.
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Affiliation(s)
- Mohammad Alasti
- Monash Cardiac Rhythm Management Department, MonashHeart, Monash Medical Centre, 246 Clayton Road, Clayton, Melbourne, Victoria, 3168, Australia.
| | - Colin Machado
- Monash Cardiac Rhythm Management Department, MonashHeart, Monash Medical Centre, 246 Clayton Road, Clayton, Melbourne, Victoria, 3168, Australia
| | - Sam Mirzaee
- Monash Cardiac Rhythm Management Department, MonashHeart, Monash Medical Centre, 246 Clayton Road, Clayton, Melbourne, Victoria, 3168, Australia
| | - Stewart Healy
- Monash Cardiac Rhythm Management Department, MonashHeart, Monash Medical Centre, 246 Clayton Road, Clayton, Melbourne, Victoria, 3168, Australia
| | - Logan Bittinger
- Monash Cardiac Rhythm Management Department, MonashHeart, Monash Medical Centre, 246 Clayton Road, Clayton, Melbourne, Victoria, 3168, Australia
| | - David Adam
- Monash Cardiac Rhythm Management Department, MonashHeart, Monash Medical Centre, 246 Clayton Road, Clayton, Melbourne, Victoria, 3168, Australia
| | - Emily Kotschet
- Monash Cardiac Rhythm Management Department, MonashHeart, Monash Medical Centre, 246 Clayton Road, Clayton, Melbourne, Victoria, 3168, Australia
| | - Jack Krafchek
- Monash Cardiac Rhythm Management Department, MonashHeart, Monash Medical Centre, 246 Clayton Road, Clayton, Melbourne, Victoria, 3168, Australia
| | - Jeffrey Alison
- Monash Cardiac Rhythm Management Department, MonashHeart, Monash Medical Centre, 246 Clayton Road, Clayton, Melbourne, Victoria, 3168, Australia
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5
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Barbhaiya CR, Niazi O, Bostrom J, Patil S, Jankelson L, Bernstein S, Park D, Holmes D, Aizer A, Chinitz LA. Early ICD lead failure in defibrillator systems with multiple leads via cephalic access. J Cardiovasc Electrophysiol 2020; 31:1462-1469. [DOI: 10.1111/jce.14523] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 04/02/2020] [Accepted: 04/07/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Chirag R. Barbhaiya
- Leon H. Charney Division of Cardiology, New York University Langone HealthNew York NY
| | - Osama Niazi
- Leon H. Charney Division of Cardiology, New York University Langone HealthNew York NY
| | - Jack Bostrom
- Leon H. Charney Division of Cardiology, New York University Langone HealthNew York NY
| | - Sachi Patil
- Leon H. Charney Division of Cardiology, New York University Langone HealthNew York NY
| | - Lior Jankelson
- Leon H. Charney Division of Cardiology, New York University Langone HealthNew York NY
| | - Scott Bernstein
- Leon H. Charney Division of Cardiology, New York University Langone HealthNew York NY
| | - David Park
- Leon H. Charney Division of Cardiology, New York University Langone HealthNew York NY
| | - Douglas Holmes
- Leon H. Charney Division of Cardiology, New York University Langone HealthNew York NY
| | - Anthony Aizer
- Leon H. Charney Division of Cardiology, New York University Langone HealthNew York NY
| | - Larry A. Chinitz
- Leon H. Charney Division of Cardiology, New York University Langone HealthNew York NY
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Marai I, Milman A, Nof E, Gurevitz O, Barlev D, Lipchenca I, Bachar S, Glikson M, Beinart R. Performance of the Linox implantable cardioverter defibrillator leads: A single‐center experience. Pacing Clin Electrophysiol 2019; 42:1524-1528. [DOI: 10.1111/pace.13816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 09/02/2019] [Accepted: 10/04/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Ibrahim Marai
- Division of Pacing and Electrophysiology, Cardiovascular Center, Baruch Padeh Poriya Medical Center, and Azrieli Faculty of MedicineBar‐Ilan University Ramat Gan Israel
- Davidai Arrhythmia Center, Levaiev Heart Institute, Sheba Medical Center, Tel Hashomer, and Sackler School of medicineTel Aviv University Tel Aviv Israel
| | - Anat Milman
- Davidai Arrhythmia Center, Levaiev Heart Institute, Sheba Medical Center, Tel Hashomer, and Sackler School of medicineTel Aviv University Tel Aviv Israel
| | - Eyal Nof
- Davidai Arrhythmia Center, Levaiev Heart Institute, Sheba Medical Center, Tel Hashomer, and Sackler School of medicineTel Aviv University Tel Aviv Israel
| | - Osnat Gurevitz
- Davidai Arrhythmia Center, Levaiev Heart Institute, Sheba Medical Center, Tel Hashomer, and Sackler School of medicineTel Aviv University Tel Aviv Israel
| | - David Barlev
- Davidai Arrhythmia Center, Levaiev Heart Institute, Sheba Medical Center, Tel Hashomer, and Sackler School of medicineTel Aviv University Tel Aviv Israel
| | - Igor Lipchenca
- Davidai Arrhythmia Center, Levaiev Heart Institute, Sheba Medical Center, Tel Hashomer, and Sackler School of medicineTel Aviv University Tel Aviv Israel
| | - Sharona Bachar
- Davidai Arrhythmia Center, Levaiev Heart Institute, Sheba Medical Center, Tel Hashomer, and Sackler School of medicineTel Aviv University Tel Aviv Israel
| | - Michael Glikson
- Davidai Arrhythmia Center, Levaiev Heart Institute, Sheba Medical Center, Tel Hashomer, and Sackler School of medicineTel Aviv University Tel Aviv Israel
| | - Roy Beinart
- Davidai Arrhythmia Center, Levaiev Heart Institute, Sheba Medical Center, Tel Hashomer, and Sackler School of medicineTel Aviv University Tel Aviv Israel
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7
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Comparison of the performance of implantable cardioverter-defibrillator leads among manufacturers. J Interv Card Electrophysiol 2019; 58:133-139. [PMID: 31691064 DOI: 10.1007/s10840-019-00640-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 09/30/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Leads are often considered the weakest link in implantable cardioverter-defibrillator (ICD) systems, and lead dysfunction is a major concern for ICD recipients. The aim of this study was to compare the lead performance from three different manufacturers. METHODS We retrospectively reviewed consecutive patients who underwent ICD system implantation at Chiba University Hospital, Japan, between March 2008 and September 2017. The following leads were implanted in our center: Durata (St. Jude Medical, St. Paul, MN, USA, now Abbott) (n = 105), Linox and LinoxSmart (Biotronik, Berlin, Germany) (n = 66), and Sprint Quattro (Medtronic, Minneapolis, MN, USA) (n = 126). RESULTS A total of 297 ICD leads were analyzed. Failure rates for Durata, Linox/LinoxSmart, and Sprint Quattro were 0.20%/patient year, 0.95%/patient year, and 1.84%/patient year, respectively, during a mean follow-up of 4.8, 6.4, and 3.0 years, respectively. The cumulative ICD lead survival probability was 98.9%, 100%, and 87.5%, after 5 years, respectively. The survival probability over the entire follow-up time as measured by the log-rank test was lower for Sprint Quattro leads than for either Durata (p = 0.011) or Linox/LinoxSmart (p = 0.028). The difference between Durata and Linox/LinoxSmart was not significant (p = 0.393). CONCLUSIONS In this single-center retrospective study, the performance of Sprint Quattro was lower than the performance of Linox/LinoxSmart and Durata leads. Large-scale, multi-center studies or manufacturer-independent registries may be necessary to confirm or reject self-reported survival probabilities from manufacturers' product performance reports.
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8
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Zungsontiporn N, Loguidice M, Daniels J. Important Parameters for Implantable Cardioverter Defibrillator Selection. Card Electrophysiol Clin 2019; 10:145-152. [PMID: 29428136 DOI: 10.1016/j.ccep.2017.11.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The efficacy of implantable cardioverter defibrillators in reducing the risk of sudden cardiac death has been well established by several clinical trials. Several factors relating to device characteristics, patient attributes, and comorbidities should be considered when selecting the appropriate implantable cardioverter defibrillators for each patient. This review examines some of these issues.
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Affiliation(s)
- Nath Zungsontiporn
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Michael Loguidice
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - James Daniels
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
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Lam A, Buehler S, Goulouti E, Sweda R, Haeberlin A, Medeiros-Domingo A, Servatius H, Seiler J, Baldinger S, Noti F, Tanner H, Roten L. Comparison of lead failure manifestation of Biotronik Linox with St. Jude Medical Riata and Medtronic Sprint Fidelis lead. J Interv Card Electrophysiol 2018; 54:161-170. [PMID: 30471050 DOI: 10.1007/s10840-018-0486-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 11/12/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare lead failure manifestation and lead performance of the Biotronik Linox/Sorin Vigila defibrillator lead (Linox group) with the St. Jude Medical Riata/Riata ST (Riata group) and Medtronic Sprint Fidelis defibrillator leads (Fidelis group). METHODS We assessed the performance of all aforementioned leads implanted at our center and investigated the manifestation of lead failures. RESULTS Of 93 Linox, 86 Riata, and 81 Fidelis leads implanted at our center, 11 (12%), 22 (26%), and 25 (31%) leads failed during a median follow-up of 46, 61, and 84 months, respectively. Inappropriate shocks were delivered in 64% (Linox), 5% (Riata), and 32% (Fidelis) of lead failures; a device alert was noted in none (Linox), 5% (Riata), and 52% (Fidelis); and lead failure was a coincidental finding in 36% (Linox), 91% (Riata), and 16% (Fidelis) of cases (p < 0.001). Non-physiological high rate signals were observed in 73% (Linox), 27% (Riata), and 80% (Fidelis) of lead failures (p = 0.001) and damaged lead integrity was found in 36% (Linox), 73% (Riata), and 24% (Fidelis) of cases (p = 0.064). Lead survival at 5 years was 88%, 92%, and 71% for Linox, Riata, and Fidelis group, respectively. CONCLUSIONS The most frequent clinical manifestation of lead failure was inappropriate shocks for Linox, coincidental finding for Riata and device alert for Fidelis leads. Non-physiological high rate signals were frequently observed in Linox and Fidelis lead failures whereas in Riata lead failures, a damaged lead integrity was the predominant finding.
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Affiliation(s)
- Anna Lam
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.,Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU) and IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux University, Pessac, Bordeaux, France
| | - Stefan Buehler
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Eleni Goulouti
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Romy Sweda
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.,ARTORG Center for Biomedical Engineering, University of Bern, 3008, Bern, Switzerland
| | - Andreas Haeberlin
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.,ARTORG Center for Biomedical Engineering, University of Bern, 3008, Bern, Switzerland
| | - Argelia Medeiros-Domingo
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Helge Servatius
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Jens Seiler
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Samuel Baldinger
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Fabian Noti
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Hildegard Tanner
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
| | - Laurent Roten
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland.
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10
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Pérez Díez D, Rubín JM, Calvo Cuervo D, García Iglesias D, Morís De La Tassa C. Analysis of early failure of Biotronik Linox Smart implantable cardioverter-defibrillator leads: A comparative study of three defibrillator leads. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2018; 41:1165-1170. [PMID: 29894002 DOI: 10.1111/pace.13385] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 04/17/2018] [Accepted: 05/07/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Early failure of Biotronik Linox and Linox Smart leads (Biotronik, Berlin, Germany) has been reported in numerous recent publications. The aim of this study was to assess the performance of this lead compared with that of two other contemporary leads. METHODS We conducted an ambispective study of all consecutive first implantations of defibrillator leads carried out in our center: Endotak (model 148, 158, Boston Scientific, Marlborough, MA, USA) (n = 173), Sprint Quattro (model 6644, 6947, Medtronic, Dublin, Ireland) (n = 145), and Linox Smart (Biotronik, model SD 65/16) (n = 120). RESULTS During a median follow-up of 4.6 ± 2.1 years, failure occurred in nine Linox Smart (7.5%), one Endotak Reliance (0.6%), and no Sprint Quattro leads. The survival probability of the Linox Smart group was significantly lower than that of the Endotak and Sprint Quattro groups measured by the log-rank test (Linox vs Endotak; P < 0.001 and Linox vs Sprint Quattro; P < 0.001). Nonphysiological signals not due to external interference were observed in all Linox Smart leads, with normal parameters and without visible anomalies on chest x-ray. CONCLUSIONS In this single-center experience, the survival rate of Linox Smart leads was 88% at 5 years of follow-up, which was significantly lower than that of the other leads. Comprehensive vigilance of Linox Smart leads, including home monitoring, may be advisable to facilitate early detection of lead failure and avoid inappropriate shocks.
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Affiliation(s)
- Diego Pérez Díez
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - José Manuel Rubín
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - David Calvo Cuervo
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Daniel García Iglesias
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - César Morís De La Tassa
- Arrhythmia Unit, Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
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11
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Weberndörfer V, Nyffenegger T, Russi I, Brinkert M, Berte B, Toggweiler S, Kobza R. First time description of early lead failure of the Linox Smart lead compared to other contemporary high-voltage leads. J Interv Card Electrophysiol 2018; 52:173-177. [DOI: 10.1007/s10840-018-0372-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 04/10/2018] [Indexed: 10/17/2022]
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12
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Prospective Assessment of Linox Implantable Cardioverter Defibrillator Leads for Structural or Electrical Abnormalities. Adv Ther 2018; 35:666-670. [PMID: 29730835 DOI: 10.1007/s12325-018-0691-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Insulation failure leading to conductor externalization (CE) of a Linox (Biotronik, Berlin, Germany) implantable cardioverter defibrillator (ICD) lead has recently been reported. The aim of this study was to assess prospectively all Linox family ICD leads implanted at our center for evidence of CE or an electrical abnormality. METHODS All patients with a Linox family ICD lead implanted at our center, between November 2007 and March 2015, were identified and all living patients were invited to attend for fluoroscopic screening and electrical assessment of the lead. RESULTS A total of 183 patients had a Linox family ICD lead implanted at our center. Of these, 5 patients (2.7%) had the lead extracted because of electrical failure and 2 of these leads had evidence of CE. Out of 158 living patients with a Linox family ICD lead, 111 patients attended for screening (mean age 63.1 years, 22.5% female). In this group of patients, no cases of CE or electrical abnormalities of the lead were identified. CONCLUSION In this study evaluating 183 patients with a Linox family ICD lead implanted at a single center, 5 leads (2.7%) were explanted because of electrical failure and 2 of these leads had evidence of CE. Prospective fluoroscopic assessment of 111 Linox family ICD leads, with a mean dwell time of 31.5 months, revealed no further cases of CE.
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13
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Kawada S, Nishii N, Morimoto Y, Miyoshi A, Tachibana M, Sugiyama H, Nakagawa K, Watanabe A, Morita H, Ito H. Comparison of longevity and clinical outcomes of implantable cardioverter-defibrillator leads among manufacturers. Heart Rhythm 2017; 14:1496-1503. [DOI: 10.1016/j.hrthm.2017.05.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Indexed: 11/25/2022]
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14
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WORDEN NICOLEE, ALQASRAWI MUSAB, MAZUR ALEXANDER. Long-Term Stability and Clinical Utility of Amplified Atrial Electrograms in a Single-Lead ICD System with Floating Atrial Electrodes. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2016; 39:1327-1334. [DOI: 10.1111/pace.12967] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 10/04/2016] [Accepted: 10/09/2016] [Indexed: 12/11/2022]
Affiliation(s)
- NICOLE E. WORDEN
- Division of Cardiovascular Medicine, University of Iowa Hospitals and Clinics; University of Iowa Carver College of Medicine; Iowa City Iowa
| | - MUSAB ALQASRAWI
- Division of Cardiovascular Medicine, University of Iowa Hospitals and Clinics; University of Iowa Carver College of Medicine; Iowa City Iowa
| | - ALEXANDER MAZUR
- Division of Cardiovascular Medicine, University of Iowa Hospitals and Clinics; University of Iowa Carver College of Medicine; Iowa City Iowa
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van Malderen SCH, Szili-Torok T, Yap SC, Hoeks SE, Zijlstra F, Theuns DAMJ. Comparative study of the failure rates among 3 implantable defibrillator leads. Heart Rhythm 2016; 13:2299-2305. [PMID: 27496586 DOI: 10.1016/j.hrthm.2016.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND After the introduction of the Biotronik Linox S/SD high-voltage lead, several cases of early failure have been observed. OBJECTIVE The purpose of this article was to assess the performance of the Linox S/SD lead in comparison to 2 other contemporary leads. METHODS We used the prospective Erasmus MC ICD registry to identify all implanted Linox S/SD (n = 408), Durata (St. Jude Medical, model 7122) (n = 340), and Endotak Reliance (Boston Scientific, models 0155, 0138, and 0158) (n = 343) leads. Lead failure was defined by low- or high-voltage impedance, failure to capture, sense or defibrillate, or the presence of nonphysiological signals not due to external interference. RESULTS During a median follow-up of 5.1 years, 24 Linox (5.9%), 5 Endotak (1.5%), and 5 Durata (1.5%) leads failed. At 5-year follow-up, the cumulative failure rate of Linox leads (6.4%) was higher than that of Endotak (0.4%; P < .0001) and Durata (2.0%; P = .003) leads. The incidence rate was higher in Linox leads (1.3 per 100 patient-years) than in Endotak and Durata leads (0.2 and 0.3 per 100 patient-years, respectively; P < .001). A log-log analysis of the cumulative hazard for Linox leads functioning at 3-year follow-up revealed a stable failure rate of 3% per year. The majority of failures consisted of noise (62.5%) and abnormal impedance (33.3%). CONCLUSION This study demonstrates a higher failure rate of Linox S/SD high-voltage leads compared to contemporary leads. Although the mechanism of lead failure is unclear, the majority presents with abnormal electrical parameters. Comprehensive monitoring of Linox S/SD high-voltage leads includes remote monitoring to facilitate early detection of lead failure.
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Affiliation(s)
| | | | - Sing C Yap
- Departments of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Sanne E Hoeks
- Anesthesiology, Erasmus MC, Rotterdam, The Netherlands
| | - Felix Zijlstra
- Departments of Cardiology, Erasmus MC, Rotterdam, The Netherlands
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