PROSPECTIVE COMPARISON OF FOUR NEW DF-4 DEFIBRILLATOR LEADS

Abstract

BackgroundOver the past few years, new DF-4 connectors have been introduced to facilitate lead connection to the device header and to reduce the size of the device. So far, there is limited publication regarding their performance, and no direct comparison exists between the different DF-4 leads.MethodThis is a prospective non-randomized study of all consecutive patients with implantation of a new DF-4 lead system at a single experimented tertiary care university centre between October 2010 and February 2015. The following single-coil DF-4 leads were evaluated: St. Jude Medical Durata 7122Q, Medtronic Sprint Quattro Secure 6935M, Boston Scientific Endotak Reliance 4-Site 0293, and Boston Scientific Reliance 4-Front 0693. This study evaluated the acute and first follow-up DF-4 lead performance as well as early peri-procedural adverse events.ResultsA total of 808 patients (age 63±12 years, 80% male, LVEF 31±12%, 58% ischemic heart disease, 35% biventricular devices) underwent implantation of a new DF-4 lead successfully. The acute and first follow-up R-wave detection and threshold were excellent for all leads in the 792 patients with complete available data (Table). A higher number of early lead revisions were required with the Boston Scientific leads compared to other leads (p=0.023). These were mostly related to lead dislodgement. The last 71 Boston Scientific 0693 leads were implanted using a standard screw activator instead of the new Boston device. There were 2 lead revisions with this new strategy (p=0.129). Rates of pneumothorax and infection requiring extraction were 0.4% and 0.8% respectively.Conclusion BackgroundOver the past few years, new DF-4 connectors have been introduced to facilitate lead connection to the device header and to reduce the size of the device. So far, there is limited publication regarding their performance, and no direct comparison exists between the different DF-4 leads. Over the past few years, new DF-4 connectors have been introduced to facilitate lead connection to the device header and to reduce the size of the device. So far, there is limited publication regarding their performance, and no direct comparison exists between the different DF-4 leads. MethodThis is a prospective non-randomized study of all consecutive patients with implantation of a new DF-4 lead system at a single experimented tertiary care university centre between October 2010 and February 2015. The following single-coil DF-4 leads were evaluated: St. Jude Medical Durata 7122Q, Medtronic Sprint Quattro Secure 6935M, Boston Scientific Endotak Reliance 4-Site 0293, and Boston Scientific Reliance 4-Front 0693. This study evaluated the acute and first follow-up DF-4 lead performance as well as early peri-procedural adverse events. This is a prospective non-randomized study of all consecutive patients with implantation of a new DF-4 lead system at a single experimented tertiary care university centre between October 2010 and February 2015. The following single-coil DF-4 leads were evaluated: St. Jude Medical Durata 7122Q, Medtronic Sprint Quattro Secure 6935M, Boston Scientific Endotak Reliance 4-Site 0293, and Boston Scientific Reliance 4-Front 0693. This study evaluated the acute and first follow-up DF-4 lead performance as well as early peri-procedural adverse events. ResultsA total of 808 patients (age 63±12 years, 80% male, LVEF 31±12%, 58% ischemic heart disease, 35% biventricular devices) underwent implantation of a new DF-4 lead successfully. The acute and first follow-up R-wave detection and threshold were excellent for all leads in the 792 patients with complete available data (Table). A higher number of early lead revisions were required with the Boston Scientific leads compared to other leads (p=0.023). These were mostly related to lead dislodgement. The last 71 Boston Scientific 0693 leads were implanted using a standard screw activator instead of the new Boston device. There were 2 lead revisions with this new strategy (p=0.129). Rates of pneumothorax and infection requiring extraction were 0.4% and 0.8% respectively. A total of 808 patients (age 63±12 years, 80% male, LVEF 31±12%, 58% ischemic heart disease, 35% biventricular devices) underwent implantation of a new DF-4 lead successfully. The acute and first follow-up R-wave detection and threshold were excellent for all leads in the 792 patients with complete available data (Table). A higher number of early lead revisions were required with the Boston Scientific leads compared to other leads (p=0.023). These were mostly related to lead dislodgement. The last 71 Boston Scientific 0693 leads were implanted using a standard screw activator instead of the new Boston device. There were 2 lead revisions with this new strategy (p=0.129). Rates of pneumothorax and infection requiring extraction were 0.4% and 0.8% respectively. Conclusion