Long-term single-center comparison of ICD lead survival: Evidence for premature Linox lead failure

ICD lead failure is a potential source of significant morbidity and mortality. This study investigates the survival rates of Sprint Quattro, Endotak Reliance, and Linox ICD leads.

A retrospective cohort study of all patients with an ICD implanted between January 2007 and December 2012 from the Wellington Hospital region, New Zealand, a tertiary referral center. Lead and patient details were established by review of clinical notes and the PaceArt Optima database. We analyzed a total of 287 implants using Sprint Quattro (n  =  92), Endotak Reliance (n  =  37), Linox (n  =  151), Riata (n  =  4), and Sprint Fidelis (n  =  2) leads. Median follow-up was 61.6 (26.0-81.6) months for Sprint Quattro leads, 66.7 (53.3-88.8) months for Linox leads, and 82.9 (45.9-107.4) months for Endotak Reliance leads. There were 20 cases of lead failure of which 19 were in Linox leads. The 4-, 6-, and 8-year survival for Linox leads was 97% (92.6-99.1), 93% (85.5-96.5), and 76% (62.3-85.5), respectively. The predominant abnormality was detection of nonphysiological electrical signals. Linox lead failure was associated with a younger age of patient (49.2 vs. 57.7 years, P  =  0.007).

The 7-year survival of Linox leads was significantly worse than shown in Biotronik surveillance reports, but in line with other single-center studies from around the world.