Lead-related complications after DDD pacemaker implantation

Maciej Debski, Mateusz Ulman, Andrzej Zabek, Krzysztof Boczar, Kazimierz Haberka, Marcin Kuniewicz, Jacek Lelakowski, Barbara Malecka

Research output: Contribution to journalArticlepeer-review

Abstract

Background:
Pacing leads remain the weakest link in pacemaker systems despite advances in manufacturing technology.

Aim:
The aim of the study was to assess the long-term pacing lead performance in an unselected real-life cohort following primary DDD pacing system implantation.

Methods:
A single-centre retrospective analysis of patients who underwent DDD pacing system implantation between October 1984 and December 2014 and were followed-up until August 2016 was conducted. The inclusion criterion was at least one follow-up visit after post-implant discharge. The performance of each atrial and ventricular lead implanted was evaluated during the follow-up period, and the incidence of, and predictive factors for, lead dislodgement and failure were analysed.

Results:
The data of 3771 patients and 24,431.8 patient-years of follow-up were analysed. The mean follow-up of patients was 77.7 ± 61.8 months. During the study period, 7887 transvenous atrial and right ventricular pacing leads were implanted. Lead dislodgement occurred in 94 (1.2%) leads (92 [2.4%] patients), perforation in 11 (0.1%) leads (10 [0.3%] patients), and lead failure in 329 (4.2%) leads (275 [7.3%] patients). Atrial lead position was a predictive factor for lead dislodgement, while age at implantation, polyurethane 80A insulation, subclavian vein access, unipolar lead construction, and lead manufacturer were multivariate predictors of lead failure.

Conclusions:
Leads with polyurethane 80A insulation, unipolar construction, and those implanted via subclavian vein puncture exhibited the worst long-term performance.
Original languageEnglish
Pages (from-to)1224-1231
JournalKardiologia polska
Volume76
Issue number8
DOIs
Publication statusPublished - 2018

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