Skip to main content
SpringerLink
Log in

Implantable cardioverter-defibrillator lead failure: how weak is the link?

  • Clinical Advance
  • Published:

From Nature Clinical Practice Cardiovascular Medicine

View current issue Sign up to alerts

Abstract

The implantable cardioverter-defibrillator (ICD) has been shown to decrease the risk of sudden cardiac death in patients when used for primary and secondary prevention. These devices are being used more frequently as indications for primary prevention broaden, and attention has become increasingly focused on complications caused by lead failure. A report using data from a large registry revealed that the cumulative incidence of lead malfunction that necessitated surgical revision of the ICD lead system was 2.5% over 5 years. A strategy to deal with failed leads by the implantation of new pace–sense leads or high-voltage leads resulted in a 20% malfunction recurrence rate at 5 years. Defibrillator leads have been termed the 'weakest link' in the ICD system. Further efforts from manufacturers, regulators, and implanting physicians are required to understand and address the causes of lead failure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Mirowski M et al. (1980) Termination of malignant ventricular arrhythmias with an implanted automatic defibrillator in human beings. N Engl J Med 303: 322–324

    Article  CAS  Google Scholar 

  2. Brown DW et al. (2008) Trends in hospitalization for the implantation of cardioverter-defibrillators in the United States, 1990–2005. Am J Cardiol 101: 1753–1755

    Article  Google Scholar 

  3. Kleemann T et al. (2007) Annual rate of transvenous defibrillation lead defects in implantable cardioverter-defibrillators over a period of >10 years. Circulation 115: 2474–2480

    Article  Google Scholar 

  4. Daubert JP et al. (2008) Inappropriate implantable cardioverter-defibrillator shocks in MADIT II: frequency, mechanisms, predictors, and survival impact. J Am Coll Cardiol 51: 1357–1365

    Article  Google Scholar 

  5. Hauser RG and Kallinen L (2004) Deaths associated with implantable cardioverter defibrillator failure and deactiviation reported in the United States Food and Drug Administration Manufacturer and User Facility Device Experience Database. Heart Rhythm 1: 399–405

    Article  Google Scholar 

  6. Maisel WH (2007) Transvenous implantable cardioverter-defibrillator leads: the weakest link. Circulation 115: 2461–2463

    Article  Google Scholar 

  7. Eckstein J et al. (2008) Necessity for surgical revision of defibrillator leads implanted long-term: causes and management. Circulation 117: 2727–2733

    Article  Google Scholar 

  8. Kallinen LM et al. (2008) Failure of impedance monitoring to prevent adverse clinical events caused by fracture of a recalled high-voltage implantable cardioverter-defibrillator lead. Heart Rhythm 5: 775–779

    Article  Google Scholar 

  9. Lloyd MS et al. (2008) More late perforations with the Riata defibrillator lead from a high-volume center: an update on the numbers. Pacing Clin Electrophysiol 31: 784–785

    Article  Google Scholar 

Download references

Author information

Author notes

  1. Johns Hopkins Hospital, 600 N Wolfe Street, Carnegie 568, Baltimore, MD 21287, USA jbrinker@jhmi.edu

Authors and Affiliations

  1. JA Brinker is Professor of Medicine and Radiology at the Johns Hopkins Medical Institutions, Baltimore, MD, USA.,

    Jeffrey A Brinker

Authors
  1. Jeffrey A Brinker
    View author publications

    You can also search for this author in PubMed Google Scholar

Ethics declarations

Competing interests

The author declares no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brinker, J. Implantable cardioverter-defibrillator lead failure: how weak is the link?. Nat Rev Cardiol 5, 758–759 (2008). https://doi.org/10.1038/ncpcardio1367

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncpcardio1367

  • Springer Nature Limited

Search

Navigation