Evidence map›Paper›PMID 38000900›Full record

ReviewEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2023

Long-term performance of single-connector (DF4) implantable defibrillator leads.

Rand Ibrahim, Mounir Al-Gibbawi, Wissam Mekary, Neal Kumar Bhatia, Soroosh Kiani, Stacy B Westerman, Anand D Shah, Michael S Lloyd, Miguel Leal, David B De Lurgio and 5 more

Open access · hybridAbstract readReview
In one paragraph

Review in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Stepping back for good reasons: a reappraisal of the DF-1 connector for defibrillator leads.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 1 institution in 1 country.

Rand IbrahimDivision of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.
Mounir Al-GibbawiDivision of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.ORCID 0000-0002-8765-4028
Wissam MekaryDivision of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.
Neal Kumar BhatiaDivision of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.ORCID 0000-0002-8021-6631
Soroosh KianiDivision of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.ORCID 0000-0001-6389-0643
Stacy B WestermanDivision of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.
Anand D ShahDivision of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.ORCID 0000-0002-3788-0297
Michael S LloydDivision of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.ORCID 0000-0002-0708-9330
Miguel LealDivision of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.ORCID 0000-0002-4797-4617
David B De LurgioDivision of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.
Anshul M PatelDivision of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.ORCID 0000-0001-6445-1773
Christine TompkinsDivision of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.ORCID 0000-0003-1153-6663
Angel R LeonDivision of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.
Faisal M MerchantDivision of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.
Mikhael F El-ChamiDivision of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 550 Peachtree Street NE, 30308 Atlanta, GA, USA.ORCID 0000-0003-4978-7177
Emory University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsSingle-connector (DF4) defibrillator leads have become the predominantly implanted transvenous implantable cardioverter-defibrillator lead. However, data on their long-term performance are derived predominantly from manufacturer product performance reports. METHODS AND

resultsWe reviewed medical records in 5289 patients with DF4 leads between 2011 and 2023 to determine the frequency of lead-related abnormalities. We defined malfunction as any single or combination of electrical abnormalities requiring revision including a sudden increase (≥2×) in stimulation threshold, a discrete jump in high-voltage impedance, or sensing of non-physiologic intervals or noise. We documented time to failure, predictors of failure, and management strategies. Mean follow-up after implant was 4.15 ± 3.6 years (median = 3.63), with 37% of leads followed for >5 years. A total of 80 (1.5%) leads demonstrated electrical abnormalities requiring revision with an average time to failure of 4 ± 2.8 years (median = 3.5). Of the leads that malfunctioned, 62/80 (78%) were extracted and replaced with a new lead and in the other 18 cases, malfunctioned DF4 leads were abandoned, and a new lead implanted. In multivariable models, younger age at implant (OR 1.03 per year; P < 0.001) and the presence of Abbott/St. Jude leads increased the risk of malfunction.

conclusionDF4 defibrillator leads demonstrate excellent longevity with >98.3% of leads followed for at least 5 years still functioning normally. Younger age at implant and lead manufacturer are associated with an increased risk of DF4 lead malfunction. The differences in lead survival between manufacturers require further investigation.

Indexed as

Defibrillators, ImplantableEquipment FailureHumansRetrospective StudiesDF1 leadsDF4 leadsICDLead failureLead revision

Identifiers

PMID38000900
PMCPMC10751803
OpenAlexW4389002993

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.