Failure Rate of ICD Leads Are Greater Than Expected

Failure rates of leads from implantable cardioverter-defibrillator devices are traditionally published by manufacturers and are generally quite low. However, these rates probably underestimate true incidence: manufacturers’ figures are based on leads that are returned after explantation, and explantation is usually performed only when a patient develops an infection or has multiple leads.

At a single center in Germany, 990 patients who underwent first implantation of an ICD from January 1992 through May 2005 were followed at 3-month intervals (mean duration of follow-up, 934 days). A total of 148 leads (15%) failed and required surgical correction. The major lead complications were insulation defects (56%), lead fractures (12%), loss of vent…