Impact of ICD lead on the system durability, predictors of long‐term survival following ICD system extraction

Abstract

ICD leads remain more vulnerable, with respect to mechanical failure and their propensity to infection, in comparison to pacing leads. Their TLE is very effective at least complication rate, when performed by a highly skilled and experienced operator. However, long-term mortality after their TLE is high and is affected mostly by infections or patient-related factors.

Echocardiographic findings in patients with cardiac implantable electronic devices—analysis of factors predisposing to lead‐associated changes

“…Subjects with high‐voltage leads and multiple‐lead systems, and those with relatively shorter lead dwell times were also more susceptible to vegetations. Most of the above described factors were reported in earlier publications (Jacheć et al, 2017; Polewczyk, Jachec, Polewczyk, et al., 2017; Polewczyk, Jachec, Tomaszewski, et al., 2017).…”

Prognostic Value of Preoperative Echocardiographic Findings in Patients Undergoing Transvenous Lead Extraction

“…The available evidence shows that CIED-related infection is the most common prognostic factor for unfavorable outcomes of TLE [5][6][7][8][9][10][11][13][14][15][17][18][19][20][21][22]. Other factors are mainly those dependent on the patient's general condition i.e., age [6,13,21,22], renal failure [5][6][7][8]10,12,13,16,[19][20][21][22], diabetes [5,16,21], heart failure [7,10,16,22], anemia [8,19], comorbidities [7]. Several studies have demonstrated the significance of procedure-related factors (system upgrade, ICD or CRT device, procedural failure, retained lead fragments, major complications, abandoned leads) [5,6,[11][12]…”

“…Other factors are mainly those dependent on the patient's general condition i.e., age [6,13,21,22], renal failure [5][6][7][8]10,12,13,16,[19][20][21][22], diabetes [5,16,21], heart failure [7,10,16,22], anemia [8,19], comorbidities [7]. Several studies have demonstrated the significance of procedure-related factors (system upgrade, ICD or CRT device, procedural failure, retained lead fragments, major complications, abandoned leads) [5,6,[11][12][13][14]16,21] (Table 5). Echocardiographic phenomena have been very rarely analyzed in terms of their impact on long-term survival after TLE A couple of papers showed only the role of so-called ghosts, i.e., post-removal, tubular, mobile masses following the lead's intracardiac route in the right-sided heart chambers [15,20].…”

“…Therefore, theoretically the fate of patients after TLE should not differ from those who did not undergo TLE. There is a large volume of published studies describing TLE outcomes, however the results are still unsatisfactory, because mortality is 5-25% at one year, 8-38% at three years, 8-44% at 5 years and 10-60% at 10 years, with the lowest values encountered in patients with non-infectious indications and highest in those with lead-related infective endocarditis (LRIE) [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Previous studies have not analyzed the effect of echocardiographic phenomena on long-term survival of patients undergoing TLE, and few reports have only assessed their relationship with the risk of procedure.…”

Initial experience with the subcutaneous implantable cardioverter-defibrillator with the real costs of hospitalization analysis in a single Polish center

“…A weak component of traditionally used ICD systems is the defibrillation lead, which is placed through the venous circulatory system into the right ventricle. It was shown that the longevity of defibrillation leads have become substantially reduced, and risk of infection is significantly higher compared to pacing leads [3]. The subcutaneous implantable cardioverter-defibrillator (S-ICD) was developed in response to endovascular lead complications and represents important progress in defibrillation technology.…”