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Title
  • en Long-term reliability of the defibrillator lead inserted by the extrathoracic subclavian puncture
Creator
    • en Watanabe, Masaya
    • en Mitsuyama, Hirofumi
    • en Mizukami, Kazuya
    • en Tenma, Taro
    • en Kamada, Rui
    • en Takahashi, Masayuki
    • en Anzai, Toshihisa
Accessrights open access
Rights
Subject
  • Other en cephalic cutdown
  • Other en defibrillator lead
  • Other en extrathoracic puncture
  • Other en lead failure
  • Other en subclavian crush syndrome
  • NDC 490
Description
  • Abstract en Background: As the transvenous defibrillator lead is fragile and its failure may cause a life-threatening event, reliable insertion techniques are required. While the extrathoracic puncture has been introduced to avoid subclavian crush syndrome, the reports on the long-term defibrillator lead survival using this approach, especially the comparison with the cephalic cutdown (CD), remain scarce. We aimed to evaluate the long-term survival of the transvenous defibrillator lead inserted by the extrathoracic subclavian puncture (ESCP) compared with CD. Methods: Between 1998 and 2011, 324 consecutive patients who underwent an implantable cardioverter-defibrillator (ICD) implantation in Hokkaido University Hospital were included. ICD leads were inserted by CD from 1998 to 2003 and by contrast venography-guided ESCP thereafter. Lead failure was defined as a nonphysiologic high-rate oversensing with abnormal lead impedance or highly elevated sensing and pacing threshold. Results: Of 324 patients, CD was used in 37 (11%) and ESCP in 287 patients (89%). During the median follow-up of 6.2 years (IQR:3.2-8.3), 7 leads (2 in CD and 5 leads in ESCP group) failed. All patients with lead failure in ESCP group were implanted with either SJM Riata (n = 1) or Medtronic Fidelis lead (n = 4). Five-year lead survival was 93.8% (CI95%:77.3-98.4%) in CD compared with 99.1% (CI95%:96.6-99.8%) in ESCP group (P = 0.903). Univariate Cox regression analysis showed that the use of Fidelis or Riata lead was the strong predictor of the ICD lead failure (HR 13.8, CI95%:2.9-96.5; P = 0.001). Conclusions: Contrast venography-guided extrathoracic puncture ensures the reliable long-term survival in the transvenous defibrillator leads.
Publisher en John Wiley & Sons
Date
    Issued2018-10
Language
  • eng
Resource Type journal article
Version Type VoR
Identifier HDL http://hdl.handle.net/2115/72045
Relation
  • isIdenticalTo DOI https://doi.org/10.1002/joa3.12107
Journal
    • PISSN 1880-4276
      • en Journal of arrhythmia
      • Volume Number34 Issue Number5 Page Start541 Page End547
File
Oaidate 2023-07-26