“Heart Wires May Pose More Risk for the Young” was the title of the article (subscription) in the Wall Street Journal this morning. The article noted the work of a fellow Northwestern University pediatric cardiologist, Wayne H. Franklin, MD who found preliminary data of higher than expected lead fracture rates in children with congenital heart disease under the age of 21. Dr. Franklin pooled data from 32 institutions who specialize in treating pediatric patients had noted a fracture rate of 6.7% of 569 patients with Medtronic’s Sprint Fidelis lead compared to Medtronic’s quoted 2.3% failure rate in the overall defibrillator population.
But what the article failed to mention was that failure rates of all types of transvenous pacing and defibrillator leads are always higher in children than in adults:
Current practice suggests that transvenous pacing leads routinely can be placed in children weighing more than 10 kg. This figure is likely to continue to decrease as pacing technology continues to reduce lead body diameter. Because of continued growth and vigorous activity, however, pediatric patients have lead fracture and failure rates distinctly higher than adults. Actual survival comparisons have been performed for transvenous pacing leads in children. These comparisons show progressive lead failure over time from fracture, insulation discontinuities, adapter/header failures, or pacing exit block.While I have no argument with the findings of Dr. Franklin, journalists using these specialists’ data to produce sensationalist headlines for business interests which serve to panic pediatric patients and families already in a difficult and fragile situation is irresponsible. I mean, is there another dog we can kick?