Key result
The Endotak lead alone showed similar 2-year survival from sudden death compared to the lead with a subcutaneous patch (98.2% vs 97.6%, P=0.38), but with fewer lead complications (3.5% vs 6.7%).
Why the study?
Does the Endotak lead system with a subcutaneous patch compared to the lead alone improve survival or reduce complications in patients with malignant ventricular arrhythmias?
Cohort (n=1,053)
Does the Endotak lead system with a subcutaneous patch compared to the lead alone improve survival or reduce complications in patients with malignant ventricular arrhythmias?
The Endotak lead alone provides excellent sudden death survival with fewer lead complications compared to the lead with a subcutaneous patch, making it the preferred choice when defibrillation thresholds are adequate.
Endotak lead alone was associated with similar survival and fewer complications; leaves open preference pending randomized confirmation.
The Endotak lead system and ICD has been used to treat patients with malignant ventricular arrhythmias. We analyzed the clinical characteristics of 1,053 patients who underwent implantation of the Endotak lead system with or without a subcutaneous patch. Group A consisted of 567 patients receiving the Endotak lead with a subcutaneous patch; group B consisted of 486 patients receiving the Endotak lead alone. The 2-year survivals from sudden death, cardiac death, and total death in groups A and B were 97.6%/98.2% (P = 0.38), 88.6%/92.7% (P = 0.09), and 84.7%/86.8% (P = 0.06), respectively. Minimum tested effective defibrillation energy at implantation was 17.2 +/- 5.2 J for group A and 15.8 +/- 5.1 J for group B (P < 0.01). The operative mortality was 1.8% in group A and 0.6% in group B (P = 0.09). The incidence of lead dislodgment, malfunction, and infection was 6.7% for group A and 3.5% for group B (P < 0.01). Sudden death survival was excellent in both groups with less lead complications in group B. The Endotak lead alone may be the preferred choice of lead configuration in those patients who have adequate defibrillation thresholds at implant.
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Jafar et al. (1997) conducted a cohort in Malignant ventricular tachyarrhythmias (n=1,053). Endotak lead alone vs. Endotak lead with a subcutaneous patch was evaluated on 2-year survival from sudden death (p=0.38). The Endotak lead alone showed similar 2-year survival from sudden death compared to the lead with a subcutaneous patch (98.2% vs 97.6%, P=0.38), but with fewer lead complications (3.5% vs 6.7%).
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