Background:
Implantable cardioverter-defibrillator therapy evolved over the decades into a well-established therapy for primary and secondary prevention of sudden cardiac death. On the other hand, lead failure is still nowadays one of the main long-term complication. The aim of the present study was to provide a long-term follow-up of leads´ failures in a large single-centre patient cohort.

Methods:
We collected retrospectively data of the patients who underwent first implantation of a defibrillator between 1993 and 2020 in our centre. Primary endpoint was defined as lead failure that required a lead revision as lead extraction or new implantation and shut down the old lead. We constructed Kaplan-Meier survival curves for the overall survival rate of each subgroup of leads.

Results:
We analysed data from 3588 leads. The median follow up was 44,8 months. A total of 272 leads encountered failure. The main reason for revision was lead fracture. The Median time to failure was 52,3 month. There are significant differences between the manufacturers and the lead types. In the overall lead survival there is a significant difference after 10 years (p=<0,0005). The best lead survival was shown by Boston Scientfic leads. After correction for special lead subgroups (like Medtronic Sprint Fidelis or Abbott Riata) to the modern leads, only numeric, no significant difference could be found.

Conclusions: Lead failure is a relevant problem in ICD Patients. Our actual cohort of patients still will become defects in leads of al manufactures, the best long term survival in our cohort has been demonstrated by Boston Scientifc leads. In the modern leads, the problem of lead defect seems to become better. The survival of actual leads is not statistically different between the different manufactures. More prospective database data is needed to analyse the further performance of the actual ICD leads.