TY - JOUR
T1 - Electrical abnormalities with St. Jude/Abbott pacing leads
T2 - A systematic review and meta-analysis
AU - Khatiwala, Roshni V.
AU - Mullins, Elizabeth
AU - Fan, Dali
AU - Srivatsa, Uma N.
AU - Dhruva, Sanket S.
AU - Oesterle, Adam
N1 - Funding Information:
Disclosures: Dr Dhruva has received funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health ( K12HL138046 ), Food and Drug Administration , the National Evaluation System for Health Technology Coordinating Center, Greenwall Foundation , Arnold Ventures, and the National Institute for Health Care Management. The rest of the authors report no conflicts of interest.
Publisher Copyright:
© 2021
PY - 2021
Y1 - 2021
N2 - Background: Although there is a paucity of contemporary data on pacemaker lead survival rates, small studies suggest that some leads may have higher malfunction rates than do others. Objective: The purpose of this study was to determine the malfunction rates of current pacemaker leads. Methods: A meta-analysis including studies that examined the non–implant-related lead malfunction rates of current commercially available active fixation pacemaker leads was performed. An electronic search of MEDLINE/PubMed, Scopus, and Embase was performed. DerSimonian and Laird random effects models were used. Results: Eight studies with a total of 14,579 leads were included. Abbott accounted for 10,838 (74%), Medtronic 2510 (17%), Boston Scientific 849 (6%), and MicroPort 382 (3%) leads. The weighted mean follow-up period was 3.6 years. Lead abnormalities occurred in 5.0% of all leads, 6.1% of Abbott leads, 1.1% of Medtronic, 1.4% of Boston Scientific, and 5.5% of MicroPort. The most common lead abnormality was lead noise with normal impedance. Abbott leads were associated with an increased risk of abnormalities (relative risk [RR] 7.81; 95% confidence interval [CI] 3.21–19.04), reprogramming (RR 7.95; 95% CI 3.55–17.82), and lead revision or extraction (RR 8.91; 95% CI 3.36–23.60). Abbott leads connected to an Abbott generator had the highest abnormality rate (8.0%) followed by Abbott leads connected to a non-Abbott generator (4.7%) and non-Abbott leads connected to an Abbott generator (0.4%). Conclusions: Abbott leads are associated with an increased risk of abnormalities compared with leads of other manufacturers, primarily manifesting as lead noise with normal impedance, and are associated with an increased risk of lead reprogramming and lead revision or extraction.
AB - Background: Although there is a paucity of contemporary data on pacemaker lead survival rates, small studies suggest that some leads may have higher malfunction rates than do others. Objective: The purpose of this study was to determine the malfunction rates of current pacemaker leads. Methods: A meta-analysis including studies that examined the non–implant-related lead malfunction rates of current commercially available active fixation pacemaker leads was performed. An electronic search of MEDLINE/PubMed, Scopus, and Embase was performed. DerSimonian and Laird random effects models were used. Results: Eight studies with a total of 14,579 leads were included. Abbott accounted for 10,838 (74%), Medtronic 2510 (17%), Boston Scientific 849 (6%), and MicroPort 382 (3%) leads. The weighted mean follow-up period was 3.6 years. Lead abnormalities occurred in 5.0% of all leads, 6.1% of Abbott leads, 1.1% of Medtronic, 1.4% of Boston Scientific, and 5.5% of MicroPort. The most common lead abnormality was lead noise with normal impedance. Abbott leads were associated with an increased risk of abnormalities (relative risk [RR] 7.81; 95% confidence interval [CI] 3.21–19.04), reprogramming (RR 7.95; 95% CI 3.55–17.82), and lead revision or extraction (RR 8.91; 95% CI 3.36–23.60). Abbott leads connected to an Abbott generator had the highest abnormality rate (8.0%) followed by Abbott leads connected to a non-Abbott generator (4.7%) and non-Abbott leads connected to an Abbott generator (0.4%). Conclusions: Abbott leads are associated with an increased risk of abnormalities compared with leads of other manufacturers, primarily manifesting as lead noise with normal impedance, and are associated with an increased risk of lead reprogramming and lead revision or extraction.
KW - Lead extraction
KW - Lead malfunction
KW - Lead noise
KW - Pacemaker lead
KW - Pacemaker programming
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U2 - 10.1016/j.hrthm.2021.08.026
DO - 10.1016/j.hrthm.2021.08.026
M3 - Article
C2 - 34461304
AN - SCOPUS:85115305607
JO - Heart Rhythm
JF - Heart Rhythm
SN - 1547-5271
ER -