Riata lead failure in pediatric and congenital heart disease patients.


Journal

Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Titre abrégé: J Cardiovasc Electrophysiol
Pays: United States
ID NLM: 9010756

Informations de publication

Date de publication:
03 2019
Historique:
received: 22 08 2018
revised: 11 12 2018
accepted: 13 12 2018
pubmed: 18 12 2018
medline: 6 5 2020
entrez: 18 12 2018
Statut: ppublish

Résumé

Implantable cardioverter defibrillator (ICD) lead failures occur at higher rates in pediatric and congenital heart disease (CHD) patients. To determine the rate and timing of Riata lead failure in pediatric and CHD patients. This was a retrospective, multicenter cohort study of pediatric patients and adults with CHD with implantation of a Riata or Riata ST lead between 2002 and 2009. The prevalence and timing of electrical failure and conductor coil externalization (CCE) were determined. Fifty-eight patients and 63 leads from seven centers were included. Median (interquartile range [IQR]) age at implant was 14.4 (11.5-18.7) years and median follow-up was 8.7 (7.3-11.1) years. The underlying diagnosis was a primary arrhythmia disorder in 45%, cardiomyopathy in 31%, and CHD in 28% of patients. Electrical failure occurred in 43% and CCE in 16% of leads at median lead ages of 4.7 (3.4-7.5) and 4.3 (3.9-7.0) years, respectively. Median lead survival free from electrical failure or CCE was 7.9 (95% confidence interval, 5.8-10.0) years. Forty-one percent of leads were functional at the end of the follow-up period, and 33% were extracted with a complication rate of 5%. The rate of Riata lead electrical failure was high in children and patients with CHD, while the rate of CCE was comparable with published data. Counseling on lead management should factor in the high rate of electrical failure with considerations for elective replacement.

Sections du résumé

BACKGROUND
Implantable cardioverter defibrillator (ICD) lead failures occur at higher rates in pediatric and congenital heart disease (CHD) patients.
OBJECTIVE
To determine the rate and timing of Riata lead failure in pediatric and CHD patients.
METHODS
This was a retrospective, multicenter cohort study of pediatric patients and adults with CHD with implantation of a Riata or Riata ST lead between 2002 and 2009. The prevalence and timing of electrical failure and conductor coil externalization (CCE) were determined.
RESULTS
Fifty-eight patients and 63 leads from seven centers were included. Median (interquartile range [IQR]) age at implant was 14.4 (11.5-18.7) years and median follow-up was 8.7 (7.3-11.1) years. The underlying diagnosis was a primary arrhythmia disorder in 45%, cardiomyopathy in 31%, and CHD in 28% of patients. Electrical failure occurred in 43% and CCE in 16% of leads at median lead ages of 4.7 (3.4-7.5) and 4.3 (3.9-7.0) years, respectively. Median lead survival free from electrical failure or CCE was 7.9 (95% confidence interval, 5.8-10.0) years. Forty-one percent of leads were functional at the end of the follow-up period, and 33% were extracted with a complication rate of 5%.
CONCLUSIONS
The rate of Riata lead electrical failure was high in children and patients with CHD, while the rate of CCE was comparable with published data. Counseling on lead management should factor in the high rate of electrical failure with considerations for elective replacement.

Identifiants

pubmed: 30556201
doi: 10.1111/jce.13812
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

320-325

Informations de copyright

© 2018 Wiley Periodicals, Inc.

Auteurs

Carolina A Escudero (CA)

Department of Pediatrics, Division of Cardiology, University of Alberta and Stollery Children's Hospital, Edmonton, Canada.

Douglas Y Mah (DY)

Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts.

Christina Y Miyake (CY)

Department of Pediatrics and Molecular Physiology & Biophysics, Baylor College of Medicine, Houston, Texas.

Elizabeth A Stephenson (EA)

Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Canada.

Martin J LaPage (MJ)

Division of Pediatric Cardiology University of Michigan, Ann Arbor, Michigan.

Peter Kubuš (P)

Children's Heart Centre, Motol University Hospital, Prague, Czech Republic.

Mitchell I Cohen (M)

Division of Cardiology, Phoenix Children's Hospital, Phoenix, Arizona.

Joseph Atallah (J)

Department of Pediatrics, Division of Cardiology, University of Alberta and Stollery Children's Hospital, Edmonton, Canada.

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