Failure Rates of Single- Versus Dual-Coil Nonrecalled Sprint Quattro Defibrillator Leads

Electrical failure is more common in single-coil compared with dual-coil implantable cardioverter defibrillator (ICD) leads in the case of the recalled Riata lead. Single-coil leads are however favored in most patients given their lower risk of extraction. We therefore evaluated the failure-free survival of single- versus dual-coil ICD leads not included in Food and Drug Administration recalls. All patients receiving a Medtronic transvenous Sprint Quattro single- or dual-coil ICD lead were included in this analysis. Leads were followed to the end point of electrical failure. A total of 1,020 dual-coil and 631 single-coil ICD leads were implanted at our institution from November 2000 to March 2014. As expected, dual-coil leads had a longer follow-up time (3.4 ± 2.6 years vs 1.3 ± 1.0 years, p <0.001) because they were approved many years earlier by the Food and Drug Administration. The overall lead survival rates free from electrical failure at 1, 2, and 3 years after implantation were 98.8%, 98.2%, and 95.1%, respectively, for the single-coil leads versus 99.7%, 99.4%, and 99.3%, respectively, for the dual-coil leads (p = 0.0013). In conclusion, single-coil leads are associated with higher electrical failure rates compared with dual-coil leads even for nonrecalled lead models from the same family and manufacturer. These findings have implications on the choice of ICD lead at the time of device implantation.