Lead- and device-related complications in the antiarrhythmics versus implantable defibrillators trial

Jack Kron, John Herre, Ellen Graham Renfroe, Carlos Rizo-Patron, Merritt Raitt, Blair Halperin, Michael Gold, Bruce Goldner, Mark Wathen, Bruce Wilkoff, Anna Olarte, Qing Yao

Research output: Contribution to journalArticle

123 Citations (Scopus)

Abstract

Background: Implantation of transvenous implantable cardioverter defibrillators (ICDs) by use of a nonthoracotomy approach has become routine therapy for survivors of life-threatening tachyarrhythmias. The purpose of this study was to identify and prospectively characterize the frequency of lead- and ICD-related complications from the Antiarrhythmics versus Implantable Defibrillators (AVID) Trial. Methods and Results: Between June 1, 1993, and April 7, 1997, 539 patients received nonthoracotomy ICDs either as initial treatment assignment (477) or as crossover from medical management (62). A total of 62 first complications occurred. The subclavian route of insertion resulted in more complications than the cephalic vein route, 46 of 339 (14%) versus 6 of 135 (4%), P = .005, as did the abdominal versus pectoral generator site, 31 of 238 (13%) versus 17 of 291 (6%), P <.02. Most dislodgements and system infections tended to occur in the 3 months after implantation, whereas lead fractures continued to occur throughout follow-up. Failure to use perioperative antibiotics was a predictor of system infection (P = .001). Conclusions: These data suggest that cephalic vein access and pectoral generator site may result in fewer complications. The continued occurrence of lead fractures and the need for premature system revision supports the practice of close routine ICD system surveillance.

Original languageEnglish (US)
Pages (from-to)92-98
Number of pages7
JournalAmerican Heart Journal
Volume141
Issue number1
DOIs
StatePublished - 2001

Fingerprint

Implantable Defibrillators
Equipment and Supplies
Veins
Head
Infection
Tachycardia
Survivors
Lead
Anti-Bacterial Agents
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Kron, J., Herre, J., Renfroe, E. G., Rizo-Patron, C., Raitt, M., Halperin, B., ... Yao, Q. (2001). Lead- and device-related complications in the antiarrhythmics versus implantable defibrillators trial. American Heart Journal, 141(1), 92-98. https://doi.org/10.1067/mhj.2001.111261

Lead- and device-related complications in the antiarrhythmics versus implantable defibrillators trial. / Kron, Jack; Herre, John; Renfroe, Ellen Graham; Rizo-Patron, Carlos; Raitt, Merritt; Halperin, Blair; Gold, Michael; Goldner, Bruce; Wathen, Mark; Wilkoff, Bruce; Olarte, Anna; Yao, Qing.

In: American Heart Journal, Vol. 141, No. 1, 2001, p. 92-98.

Research output: Contribution to journalArticle

Kron, J, Herre, J, Renfroe, EG, Rizo-Patron, C, Raitt, M, Halperin, B, Gold, M, Goldner, B, Wathen, M, Wilkoff, B, Olarte, A & Yao, Q 2001, 'Lead- and device-related complications in the antiarrhythmics versus implantable defibrillators trial', American Heart Journal, vol. 141, no. 1, pp. 92-98. https://doi.org/10.1067/mhj.2001.111261
Kron, Jack ; Herre, John ; Renfroe, Ellen Graham ; Rizo-Patron, Carlos ; Raitt, Merritt ; Halperin, Blair ; Gold, Michael ; Goldner, Bruce ; Wathen, Mark ; Wilkoff, Bruce ; Olarte, Anna ; Yao, Qing. / Lead- and device-related complications in the antiarrhythmics versus implantable defibrillators trial. In: American Heart Journal. 2001 ; Vol. 141, No. 1. pp. 92-98.
@article{6d33dbbe2edc4f28b40bbe92d4f235d7,
title = "Lead- and device-related complications in the antiarrhythmics versus implantable defibrillators trial",
abstract = "Background: Implantation of transvenous implantable cardioverter defibrillators (ICDs) by use of a nonthoracotomy approach has become routine therapy for survivors of life-threatening tachyarrhythmias. The purpose of this study was to identify and prospectively characterize the frequency of lead- and ICD-related complications from the Antiarrhythmics versus Implantable Defibrillators (AVID) Trial. Methods and Results: Between June 1, 1993, and April 7, 1997, 539 patients received nonthoracotomy ICDs either as initial treatment assignment (477) or as crossover from medical management (62). A total of 62 first complications occurred. The subclavian route of insertion resulted in more complications than the cephalic vein route, 46 of 339 (14{\%}) versus 6 of 135 (4{\%}), P = .005, as did the abdominal versus pectoral generator site, 31 of 238 (13{\%}) versus 17 of 291 (6{\%}), P <.02. Most dislodgements and system infections tended to occur in the 3 months after implantation, whereas lead fractures continued to occur throughout follow-up. Failure to use perioperative antibiotics was a predictor of system infection (P = .001). Conclusions: These data suggest that cephalic vein access and pectoral generator site may result in fewer complications. The continued occurrence of lead fractures and the need for premature system revision supports the practice of close routine ICD system surveillance.",
author = "Jack Kron and John Herre and Renfroe, {Ellen Graham} and Carlos Rizo-Patron and Merritt Raitt and Blair Halperin and Michael Gold and Bruce Goldner and Mark Wathen and Bruce Wilkoff and Anna Olarte and Qing Yao",
year = "2001",
doi = "10.1067/mhj.2001.111261",
language = "English (US)",
volume = "141",
pages = "92--98",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "1",

}

TY - JOUR

T1 - Lead- and device-related complications in the antiarrhythmics versus implantable defibrillators trial

AU - Kron, Jack

AU - Herre, John

AU - Renfroe, Ellen Graham

AU - Rizo-Patron, Carlos

AU - Raitt, Merritt

AU - Halperin, Blair

AU - Gold, Michael

AU - Goldner, Bruce

AU - Wathen, Mark

AU - Wilkoff, Bruce

AU - Olarte, Anna

AU - Yao, Qing

PY - 2001

Y1 - 2001

N2 - Background: Implantation of transvenous implantable cardioverter defibrillators (ICDs) by use of a nonthoracotomy approach has become routine therapy for survivors of life-threatening tachyarrhythmias. The purpose of this study was to identify and prospectively characterize the frequency of lead- and ICD-related complications from the Antiarrhythmics versus Implantable Defibrillators (AVID) Trial. Methods and Results: Between June 1, 1993, and April 7, 1997, 539 patients received nonthoracotomy ICDs either as initial treatment assignment (477) or as crossover from medical management (62). A total of 62 first complications occurred. The subclavian route of insertion resulted in more complications than the cephalic vein route, 46 of 339 (14%) versus 6 of 135 (4%), P = .005, as did the abdominal versus pectoral generator site, 31 of 238 (13%) versus 17 of 291 (6%), P <.02. Most dislodgements and system infections tended to occur in the 3 months after implantation, whereas lead fractures continued to occur throughout follow-up. Failure to use perioperative antibiotics was a predictor of system infection (P = .001). Conclusions: These data suggest that cephalic vein access and pectoral generator site may result in fewer complications. The continued occurrence of lead fractures and the need for premature system revision supports the practice of close routine ICD system surveillance.

AB - Background: Implantation of transvenous implantable cardioverter defibrillators (ICDs) by use of a nonthoracotomy approach has become routine therapy for survivors of life-threatening tachyarrhythmias. The purpose of this study was to identify and prospectively characterize the frequency of lead- and ICD-related complications from the Antiarrhythmics versus Implantable Defibrillators (AVID) Trial. Methods and Results: Between June 1, 1993, and April 7, 1997, 539 patients received nonthoracotomy ICDs either as initial treatment assignment (477) or as crossover from medical management (62). A total of 62 first complications occurred. The subclavian route of insertion resulted in more complications than the cephalic vein route, 46 of 339 (14%) versus 6 of 135 (4%), P = .005, as did the abdominal versus pectoral generator site, 31 of 238 (13%) versus 17 of 291 (6%), P <.02. Most dislodgements and system infections tended to occur in the 3 months after implantation, whereas lead fractures continued to occur throughout follow-up. Failure to use perioperative antibiotics was a predictor of system infection (P = .001). Conclusions: These data suggest that cephalic vein access and pectoral generator site may result in fewer complications. The continued occurrence of lead fractures and the need for premature system revision supports the practice of close routine ICD system surveillance.

UR - http://www.scopus.com/inward/record.url?scp=0035169738&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035169738&partnerID=8YFLogxK

U2 - 10.1067/mhj.2001.111261

DO - 10.1067/mhj.2001.111261

M3 - Article

C2 - 11136492

AN - SCOPUS:0035169738

VL - 141

SP - 92

EP - 98

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 1

ER -