Safety and efficacy of transvenous high-voltage implantable cardioverter-defibrillator leads in high-risk hypertrophic cardiomyopathy patients

Robert G. Hauser, Barry J. Maron, Joseph E. Marine, Rachel Lampert, Alan H. Kadish, Stephen L. Winters, David L. Scher, Mazda Biria, Amit Kalia

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The implantable cardioverter-defibrillator (ICD) prevents sudden cardiac death in high-risk patients with hypertrophic cardiomyopathy (HCM). However, recently concerns have been raised regarding the performance of transvenous high-voltage ICD leads (HVL) in this population. Objective: The purpose of this retrospective, multicenter study was to assess the safety and efficacy of HVL in high-risk HCM patients. Methods: The study population consisted of HCM patients who received HVL ICDs and were subsequently followed at seven centers in the United States. Kaplan-Meier survival rates were calculated for HVL and patients. HVL failure was a malfunction caused by a noniatrogenic defect. Results: Between 1992 and 2007, 324 HCM patients (mean age 47 ± 16 years) received 343 HVL from three major manufacturers. The average HVL implant duration was 3.3 ± 2.8 years. Overall, the HVL failure rate was 1.4%/year. However, two models (Sprint Fidelis and Transvene, Medtronic, Inc.) accounted for 60% of HVL failures. Survival probabilities for HVL and patients at 10 years were 93% and 91%, respectively. No deaths or serious injuries were reported, although inappropriate shocks occurred in 12% of cases. Conclusions: This multicenter experience shows that HVLs are safe and effective in high-risk HCM patients. However, differences in failure rates were found between lead models.

Original languageEnglish (US)
Pages (from-to)1517-1522
Number of pages6
JournalHeart Rhythm
Volume5
Issue number11
DOIs
StatePublished - Nov 2008

Keywords

  • High-voltage ICD leads
  • Hypertrophic cardiomyopathy
  • Implantable cardioverter-defibrillator

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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