Managing patients with advisory defibrillator leads: what can we learn from published data?
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  • 作者:F. A. Bracke (1)
    B. M. van Gelder (1)

    1. Department of Cardiology
    ; Catharina Hospital ; Michelangelolaan 2 ; 5623 EJ ; Eindhoven ; The Netherlands
  • 关键词:Defibrillators ; Implantable ; Electrodes ; Implanted ; Complications ; Advisory leads
  • 刊名:Netherlands Heart Journal
  • 出版年:2015
  • 出版时间:April 2015
  • 年:2015
  • 卷:23
  • 期:4
  • 页码:199-204
  • 全文大小:370 KB
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  • 刊物主题:Medicine/Public Health, general;
  • 出版者:Bohn Stafleu van Loghum
  • ISSN:1876-6250
文摘
Defibrillator lead advisories stir a lot of emotions, both with patients and physicians, and this may influence lead management. We reviewed the literature for a more evidence-based approach to this issue. From the complications of two of the current advisory leads, the Medtronic Sprint Fidelis and St. Jude Riata leads, and the consequences of possible interventions, we can conclude that a restrained approach to premature replacement is appropriate. It may be opportune to replace the leads during a scheduled generator replacement in case of a higher electrical failure rate, in order to prevent future premature interventions. We found no support to extract non-functional advisory leads. In contrast, extraction is often more demanding than anticipated, and the risk substantially exceeds that of simply abandoning the leads.

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