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[Clinical study on 29 pacemaker and defibrillator lead fractures]
Min Tang1, Ke-ping Chen, Fang-zheng Wang
1Department of Arrhythmia, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Zhonghua Xin Xue Guan Bing Za Zhi
|November 4, 2005
Summary
Cephalic venotomy is the preferred method for pacemaker and implantable cardioverter-defibrillator (ICD) implantation, showing a lower lead fracture incidence. Regular follow-up aids in early detection and management of lead fractures.
Area of Science:
- Cardiovascular medicine
- Biomedical engineering
- Implantable electronic devices
Context:
- Lead fractures are a significant complication of pacemakers and implantable cardioverter-defibrillators (ICDs).
- Understanding the causes and locations of lead fractures is crucial for improving device longevity and patient outcomes.
- Previous implantation techniques may influence the incidence of lead fractures.
Purpose:
- To analyze the probable causes, locations, and remedies for lead fractures in implanted pacemakers and ICDs.
- To compare the incidence of lead fractures based on different implantation methods.
- To identify optimal strategies for managing lead fractures.
Summary:
- A study of 4698 pacemakers and 161 ICDs revealed a 0.6% lead fracture incidence.
- Subclavian venipuncture had a higher fracture rate (0.9%) than cephalic venotomy (0.4%).
- Fractures commonly occurred at the subclavicular region; cephalic venotomy is recommended as the primary implantation method.
Impact:
- Recommends cephalic venotomy as the preferred implantation technique to reduce lead fracture risk.
- Highlights the importance of regular device follow-up for early detection and management of lead fractures.
- Provides insights into common fracture locations, aiding in surgical planning and lead design.