Abstract 17736: ICD Lead Performance in Athletes: Long-term Results of a Prospective Multinational Registry

BackgroundAthletic activity, especially including those with repetitive upper extremity motion, may increase the risk of lead failure in those with an implanted defibrillator (ICD). A prospective international registry has followed athletes with ICDs. The current study is an analysis of this registry focusing on lead failures.HypothesisLead failures will be increased in those participating in sports.MethodsAthletes with transvenous ICDs (age 10-60 years) participating in sports were enrolled in a prospective international registry. Contact sports were defined based on American Academy of Pediatrics definitions. Clinical outcomes including lead failure (nonphysiologic noise or significant changes in sensing or pacing) were adjudicated by two electrophysiologists.ResultsThe registry enrolled 440 athletes with an ICD. Median age was 33 years (111 < 20 yrs); 33% were female. Running, basketball, and soccer were the most common sports. Over a median follow-up of 44 months, (IQR 30-48), there were 44 lead failures. Multivariate predictors of lead failure were younger age (HR=0.90/5 year younger, 95% CI0.80-1.00; p=.05), presence of a Fidelis lead (HR 3.12, 95% CI 1.87-7.15; p=0.003) versus non-recalled leads, with a trend for Riata/Riata ST/Riata ST Optima leads vs non-recalled leads (HR 1.92, 95% CI 0.78, 4.74; p=0.16). Type of structural heart disease, venous access (subclavian vs cephalic), number of leads, gender, participation in contact sports, sports with intense arm activity (e.g. swimming), or time spent weight lifting did not predict lead failure.ConclusionsOverall lead failure rate in non-recalled leads (89.0%% over ten years) is similar to that reported in the general population. In this cohort of 440 athletes, intense arm activity and contact sports did not predict lead failure compared to those not engaged in these activities.