Does implantation technique infl uence lead failure?

Abstract

Objective We aimed to analyse whether diff erent lead implantation techniques infl uence lead failure based on implant duration.Methods and results Eighty-two transvenous leads were extracted due to lead failure. Median implant duration (MID) of the extracted leads was 68 months. Failed leads were retrospectively divided into 5 subgroups according to predefi ned technical procedural aspects, potentially triggering lead failure: venous approach, lead disorder in the generator pocket, sharp lead angulation, lead-lead interaction and number of leads in situ. The subgroupswere correlated to the MID and compared. The MID was 81 vs 59 months in medial vs lateral venous puncture (P = 0.453). In subgroups without/with lead disorder the MID was 59 vs 107 months (P = 0.006) and 57 vs 84 months (P = 0.012) in subgroups without/with sharp lead angulation, respectively. In subgroups without/with more than 1 lead-lead interaction the MID was 59 vs 81 months (P = 0.029) and 65 vs 86 months (P = 0.128) without/with more than 2 lead-lead interactions, respectively. In subgroups without/with more than 1 lead in situ the MID was 73 vs 67 months (P = 0.453), 81 vs 27 months (P = 0.296) in subgroups without/with more than 2 leads in situ and 68 vs 77 months (P = 0.264) in subgroups without/with more than 3 leads in situ, respectively.Conclusions Although, we were able to confi rm our hypothesis only partially, technical aspects of lead implantation technique should be kept in mind as a potential reason causing lead failure.