[en] Sprint Fidelis defibrillation leads are prone to early failure. Most of the reported series come from a single institution. This paper describes the clinical experience in nine Spanish hospitals. Clinical, implant, and follow-up data of all patients with a Sprint Fidelis lead were analyzed. All cases of lead failure were identified, medium-term lead survival was calculated, and possible predictors for lead failure were determined. In total, 378 leads in 376 patients were studied. The mean age (male 85.7%) was 64.9 ? 13.6 years. The majority of patients (59.8%) had ischemic heart disease. Mean left ventricular ejection fraction was 33.4% ? 14.5%. Left subclavian vein puncture was used in 74.8%. During a mean follow-up of 30.9 ? 14 months, 16 lead failures have occurred, with a lead survival of 96.1% at 36 months after implantation. Eleven of 16 lead failures were caused by failure of pace/sense conductors, 3 by defects in the high-voltage conductor, and 2 by defects in both types of conductors. A less depressed left ventricular ejection fraction was associated with an increased probability of lead failure (42.4% ? 16% vs. 33% ? 14.3%; P =.011). Three hospitals presented a rate of lead failure higher than 10%; the rate was less than 5% in the remaining 6 hospitals. In this multicenter series of 378 leads, the 3-year estimated survival was higher than that reported in prior series. Clinical presentation of lead failures was similar to that reported previously. Left ventricular ejection fraction and hospital of implantation were variables associated to lead failure.

[es] ntroducci?n y objetivos Los electrodos de desfibrilaci?n Sprint Fidelis presentan riesgo de disfunci?n precoz. La mayor parte de las series en la literatura provienen de un solo centro. Describimos la experiencia cl?nica en nueve centros espa?oles. M?todos Se analizaron los datos cl?nicos, del implante y el seguimiento de todos los pacientes con un electrodo Sprint Fidelis, describiendo los casos problema, calculando la supervivencia del electrodo a medio plazo e identificando posibles predictores de disfunci?n. Resultados Se incluy? un total de 378 electrodos en 376 pacientes (el 85,7% varones), con una media de edad de 64,9?13,6 a?os. El 59,8% se implant? en pacientes con cardiopat?a isqu?mica. La fracci?n de eyecci?n ventricular izquierda era 33,4%?14,5%. En el 74,8% de los casos se implant? por punci?n subclavia izquierda. Tras un seguimiento medio de 30,9?14 meses, 16 pacientes presentaron disfunci?n del electrodo; la supervivencia a 36 meses fue del 96,1%. En 11 electrodos ocurri? una disfunci?n aislada del sistema de sensado/estimulaci?n; en 3, del sistema de alta energ?a, y en 2, de ambos. Una mejor funci?n ventricular se asoci? con una mayor probabilidad de fractura del electrodo (el 42,4%?16% frente al 33%?14,3%; p=0,011); tres centros presentaron una tasa de fracturas superior al 10% y los seis restantes, inferior al 5%. Conclusiones En esta serie multic?ntrica de 378 electrodos, la supervivencia estimada a 3 a?os result? mayor que en series previas, con un perfil de presentaci?n cl?nica similar de las disfunciones. La fracci?n de eyecci?n ventricular izquierda y el centro implantador fueron variables asociadas a la presencia de disfunci?n.