Key result
The Medtronic 4012 ventricular lead had significantly poorer survival compared to the average of all ventricular leads (P=0.01), while atrial lead models showed stable survival.
Why the study?
Do specific pacing lead models have different survival rates compared to the average lead?
Cohort (n=2,444)
No
Do specific pacing lead models have different survival rates compared to the average lead?
Certain ventricular pacing leads, specifically the Medtronic 4012, demonstrate significantly poorer long-term survival compared to average leads, necessitating frequent follow-up.
Answers are grounded in this paper and cite their sources.
Some leads show poor long-term survival; confirms model variability but leaves open prospective monitoring standards.
UNLABELLED: Recent reports have shown poor survival of some leads currently in use. Long-term survival analysis of 2,444 leads (1,059 atrial and 1,385 ventricular) implanted in this institution since January 1980, and having at least 1 month of follow-up was performed. The survival of 123 different models was compared with the average survival of all the leads implanted in the corresponding chamber. Failure was defined as inactivation of the lead (electrical abandonment, explant, or cap) due to insulator and/or conductor fracture. RESULTS: The mean follow-up was 33 +/- 32 months. The cumulative survival for different atrial lead models was consistent with the average performance in the atrium. No atrial lead showed better or worse survival compared to the others. In the ventricular group, the Medtronic 4012 lead showed statistically significant poorer survival (P = 0.01) compared with the average survival of the ventricular leads. The Cardiac Pacemakers, Inc. (CPI) 4010 lead showed a nonsignificant (P = 0.12) worse performance than the average for ventricular leads. CONCLUSIONS: (1) The Medtronic 4012 had a significantly poorer performance than the rest of the leads. A trend in similar direction was found for the CPI 4010, also in the ventricular group; (2) Atrial lead models showed a stable survival; and (3) Frequent follow-up is required for some leads, especially in pacemaker dependent patients.
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Woscoboinik et al. (1992) conducted a cohort in Pacemaker implantation (n=2,444). Specific pacing lead models (e.g., Medtronic 4012) vs. Average survival of all leads implanted in the corresponding chamber was evaluated on Lead failure (inactivation due to insulator and/or conductor fracture) (p=0.01). The Medtronic 4012 ventricular lead had significantly poorer survival compared to the average of all ventricular leads (P=0.01), while atrial lead models showed stable survival.
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