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Updated: Jul 10, 2025
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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
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Long-term performance of single-connector (DF4) implantable defibrillator leads
Rand Ibrahim1, Mounir Al-Gibbawi1, Wissam Mekary1
1Division of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.
Summary
Single-connector (DF4) defibrillator leads show excellent long-term performance, with over 98.3% functioning normally after 5 years. Younger patient age and specific lead manufacturers are linked to a higher risk of DF4 lead malfunction.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Single-connector (DF4) defibrillator leads are now standard for transvenous implantable cardioverter-defibrillator systems.
- Existing long-term performance data primarily rely on manufacturer reports.
Approach:
- Retrospective review of medical records for 5289 patients implanted with DF4 leads between 2011 and 2023.
- Defined and documented lead-related electrical abnormalities requiring revision, time to failure, and predictors.
- Analyzed management strategies for malfunctioning leads.
Key Points:
- Overall, 1.5% (80/5289) of DF4 leads experienced electrical abnormalities requiring revision, with a mean time to failure of 4 years.
- Younger age at implantation (OR 1.03 per year) and the use of Abbott/St. Jude manufactured leads were identified as significant predictors of malfunction.
- The majority of malfunctioning leads (78%) were extracted and replaced; others were abandoned in favor of new leads.
Conclusions:
- DF4 defibrillator leads exhibit robust longevity, with over 98.3% maintaining normal function at 5 years.
- Patient age at implantation and lead manufacturer are critical factors influencing the risk of DF4 lead malfunction.
- Further research is warranted to understand the disparities in lead survival rates among different manufacturers.
