Unexpected high failure rate of a specific MicroPort/LivaNova/Sorin pacing lead.


Journal

Heart rhythm
ISSN: 1556-3871
Titre abrégé: Heart Rhythm
Pays: United States
ID NLM: 101200317

Informations de publication

Date de publication:
01 2021
Historique:
received: 17 05 2020
revised: 01 08 2020
accepted: 09 08 2020
pubmed: 18 8 2020
medline: 18 11 2021
entrez: 18 8 2020
Statut: ppublish

Résumé

Pacing leads are the Achilles heel of pacemakers. Most manufacturers report a 3-year survival rate of >99% of their leads. We observed several failures of the Beflex/Vega leads (MicroPort, Shanghai, China; formerly Sorin/LivaNova). The purpose of this study was to investigate failure rates of Beflex/Vega leads. We analyzed the performance of Beflex/Vega leads implanted at our tertiary referral center. All-cause lead failures (any issues requiring reinterventions such as lead dislocations, cardiac perforations, and electrical abnormalities) were identified during follow-up. The Beflex/Vega lead was compared with a reference lead (CapSureFix Novus 5076, Medtronic, Minneapolis, MN) implanted within the same period and by the same operators. A total of 585 leads were analyzed (382 Beflex/Vega and 203 CapSureFix Novus 5076 leads). Cumulative failure rate estimates were 5.2%, 6.3%, and 12.4% after 1, 2, and 3 years for the Beflex/Vega lead. This was worse compared to the reference lead (1.5%, 1.5%, 3.7% after 1, 2, and 3 years; P = .001). Early failure manifestations up to 3 months occurred at a similar rate (Beflex/Vega vs CapSureFix Novus 5076 lead: 1.3% vs 0.5% for dislocations; 1.3% vs 1.0% for perforations). During follow-up, electrical abnormalities such as noise oversensing (P = .013) and increased pacing thresholds (P = .003) became more frequent in the Beflex/Vega group. Electrical abnormalities were the most common failure manifestation 3 years after implantation in this group (9.4% vs 2.2% for the CapSureFix Novus 5076). The failure rate of the Beflex/Vega lead of >10% after 3 years was higher than that of a competitor lead. This gives rise to concern since >135,000 such leads are active worldwide.

Sections du résumé

BACKGROUND
Pacing leads are the Achilles heel of pacemakers. Most manufacturers report a 3-year survival rate of >99% of their leads. We observed several failures of the Beflex/Vega leads (MicroPort, Shanghai, China; formerly Sorin/LivaNova).
OBJECTIVE
The purpose of this study was to investigate failure rates of Beflex/Vega leads.
METHODS
We analyzed the performance of Beflex/Vega leads implanted at our tertiary referral center. All-cause lead failures (any issues requiring reinterventions such as lead dislocations, cardiac perforations, and electrical abnormalities) were identified during follow-up. The Beflex/Vega lead was compared with a reference lead (CapSureFix Novus 5076, Medtronic, Minneapolis, MN) implanted within the same period and by the same operators.
RESULTS
A total of 585 leads were analyzed (382 Beflex/Vega and 203 CapSureFix Novus 5076 leads). Cumulative failure rate estimates were 5.2%, 6.3%, and 12.4% after 1, 2, and 3 years for the Beflex/Vega lead. This was worse compared to the reference lead (1.5%, 1.5%, 3.7% after 1, 2, and 3 years; P = .001). Early failure manifestations up to 3 months occurred at a similar rate (Beflex/Vega vs CapSureFix Novus 5076 lead: 1.3% vs 0.5% for dislocations; 1.3% vs 1.0% for perforations). During follow-up, electrical abnormalities such as noise oversensing (P = .013) and increased pacing thresholds (P = .003) became more frequent in the Beflex/Vega group. Electrical abnormalities were the most common failure manifestation 3 years after implantation in this group (9.4% vs 2.2% for the CapSureFix Novus 5076).
CONCLUSION
The failure rate of the Beflex/Vega lead of >10% after 3 years was higher than that of a competitor lead. This gives rise to concern since >135,000 such leads are active worldwide.

Identifiants

pubmed: 32798776
pii: S1547-5271(20)30765-7
doi: 10.1016/j.hrthm.2020.08.010
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

41-49

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2020 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Auteurs

Andreas Haeberlin (A)

Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Sitem Center for Translational Medicine and Biomedical Entrepreneurship, University of Bern, Bern, Switzerland; Bordeaux University Hospital (CHU), Cardio-Thoracic Unit, Pessac, France. Electronic address: andreas.haeberlin@insel.ch.

Marie-Theres Anwander (MT)

Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Thomas Kueffer (T)

Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Maximilien Tholl (M)

Sitem Center for Translational Medicine and Biomedical Entrepreneurship, University of Bern, Bern, Switzerland.

Samuel Baldinger (S)

Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Helge Servatius (H)

Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Anna Lam (A)

Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Florian Franzeck (F)

Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Babken Asatryan (B)

Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Adrian Zurbuchen (A)

Sitem Center for Translational Medicine and Biomedical Entrepreneurship, University of Bern, Bern, Switzerland.

Hildegard Tanner (H)

Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Tobias Reichlin (T)

Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Laurent Roten (L)

Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Fabian Noti (F)

Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

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