Woscoboinik J R, Maloney J D, Helguera M E, Mercho N, Alexander L A, Wilkoff B, Simmons T, Morant V, Castle L W
Department of Cardiology, Cleveland Clinic Foundation, Ohio 44195.
Pacing Clin Electrophysiol. 1992 Nov;15(11 Pt 2):1991-5. doi: 10.1111/j.1540-8159.1992.tb03008.x.
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.
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.
(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.
近期报告显示，目前使用的一些导线生存率较低。对自1980年1月起在本机构植入的2444根导线（1059根心房导线和1385根心室导线）进行了长期生存分析，且这些导线至少随访了1个月。将123种不同型号的生存率与相应心腔内植入的所有导线的平均生存率进行了比较。故障定义为由于绝缘体和/或导体断裂导致导线失活（电遗弃、取出或封帽）。
平均随访时间为33±32个月。不同心房导线型号的累积生存率与心房的平均表现一致。与其他心房导线相比，没有一种心房导线显示出更好或更差的生存率。在心室组中，美敦力4012导线的生存率与心室导线的平均生存率相比，在统计学上显著较差（P = 0.01）。心脏起搏器公司（CPI）4010导线的表现比心室导线的平均水平略差，但无统计学意义（P = 0.12）。
（1）美敦力4012导线的表现明显比其他导线差。在心室组中，CPI 4010导线也呈现出类似的趋势；（2）心房导线型号的生存率稳定；（3）对于一些导线，尤其是依赖起搏器的患者，需要频繁随访。
