Long-term reliability of the defibrillator lead inserted by the extrathoracic subclavian puncture

Watanabe, Masaya; Yokoshiki, Hisashi; Mitsuyama, Hirofumi; Mizukami, Kazuya; Tenma, Taro; Kamada, Rui; Takahashi, Masayuki; Matsui, Yoshiro; Anzai, Toshihisa

Long-term reliability of the defibrillator lead inserted by the extrathoracic subclavian puncture

Watanabe, Masaya; Yokoshiki, Hisashi; Mitsuyama, Hirofumi et al.

Journal of arrhythmia, 2018, 34(5), 541-547

Permalink : https://hdl.handle.net/2115/72045

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アクセス権	open access
URI	https://hdl.handle.net/2115/72045
タイトル	Long-term reliability of the defibrillator lead inserted by the extrathoracic subclavian puncture
著者	Watanabe, Masaya ; Yokoshiki, Hisashi ; Mitsuyama, Hirofumi ; Mizukami, Kazuya ; Tenma, Taro ; Kamada, Rui ; Takahashi, Masayuki ; Matsui, Yoshiro ; Anzai, Toshihisa
著者名 Watanabe, Masaya
e-Rad_Researcher 40360911 著者名 Yokoshiki, Hisashi
著者名 Mitsuyama, Hirofumi
著者名 Mizukami, Kazuya
著者名 Tenma, Taro
著者名 Kamada, Rui
著者名 Takahashi, Masayuki
e-Rad_Researcher 90219379 著者名 Matsui, Yoshiro
著者名 Anzai, Toshihisa
言語	英語
キーワード	cephalic cutdown
	defibrillator lead
	extrathoracic puncture
	lead failure
	subclavian crush syndrome
発行日	2018-10
出版者	John Wiley & Sons
収録物名	Journal of arrhythmia
巻(号)	34(5)
ページ	541-547
抄録	Background: As the transvenous defibrillator lead is fragile and its failure may cause a life-threatening event, reliable insertion techniques are required. While the extrathoracic puncture has been introduced to avoid subclavian crush syndrome, the reports on the long-term defibrillator lead survival using this approach, especially the comparison with the cephalic cutdown (CD), remain scarce. We aimed to evaluate the long-term survival of the transvenous defibrillator lead inserted by the extrathoracic subclavian puncture (ESCP) compared with CD. Methods: Between 1998 and 2011, 324 consecutive patients who underwent an implantable cardioverter-defibrillator (ICD) implantation in Hokkaido University Hospital were included. ICD leads were inserted by CD from 1998 to 2003 and by contrast venography-guided ESCP thereafter. Lead failure was defined as a nonphysiologic high-rate oversensing with abnormal lead impedance or highly elevated sensing and pacing threshold. Results: Of 324 patients, CD was used in 37 (11%) and ESCP in 287 patients (89%). During the median follow-up of 6.2 years (IQR:3.2-8.3), 7 leads (2 in CD and 5 leads in ESCP group) failed. All patients with lead failure in ESCP group were implanted with either SJM Riata (n = 1) or Medtronic Fidelis lead (n = 4). Five-year lead survival was 93.8% (CI95%:77.3-98.4%) in CD compared with 99.1% (CI95%:96.6-99.8%) in ESCP group (P = 0.903). Univariate Cox regression analysis showed that the use of Fidelis or Riata lead was the strong predictor of the ICD lead failure (HR 13.8, CI95%:2.9-96.5; P = 0.001). Conclusions: Contrast venography-guided extrathoracic puncture ensures the reliable long-term survival in the transvenous defibrillator leads.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
権利情報	Creative Commons Attribution-NonCommercial 4.0 International
PISSN	1880-4276
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1002/joa3.12107