[Lead survival and complications (except infections). Are we doing better nowadays?]

In the last decade manufacturers of cardiac rhythm management devices focused mainly on the reduction of both device and lead size. Furthermore the implementation of additional functions like cardiac monitoring and new algorithms as well as increasing defibrillation safety through higher energy delivery became of greater interest. The FDA recall (class I) of some of the commonly used ICD leads led to a change in thinking in ICD therapy, more attention to device and lead function control in addition to the increased awareness of lead complications. These issues changed our daily behaviour in ICD implantation and follow up effectively. The following article gives an overview of ICD lead performance, suitable recalls, complications as well as available control functions. The need for improved market supervision of lead function in the medical community and proven alternative device therapies for selected patients is being discussed.