Long-Term Consequences of Endocardial Leads Present in Cardiovascular System

Endocardial leads for permanent heart stimulation and cardioverter/defibrillator ones have been implanted for 52 and 20 years, respectively. From the very beginning of the age of heart stimulation with the use of endocardial leads, there have been considered reactions of coagulation and immunological systems as well as the changes to the endocardium and the blood vessels in response to the leads in them. In the technological process the leads are covered by external insulation made by polymer materials with bio-compatible properties, that is ones not inducing side effects. Mass implantation of systems for permanent stimulation and implantable cardioverter/defibrillator (ICD) could take place only at the age of developed electronics. Recently we have celebrated the 50th anniversary of permanent heart stimulation. Since that time the number of patients with cardio implants in the right heart have proliferated and also their life expectancy have become substantially prolonged. Over a 50 year-old history of permanent heart stimulation presents a number of arguments to show that ideas of full bio-compatibility of polymer covered leads (usually silicone and polyurethane) were only a wishful thinking. Patients with pacemaker (PM) and ICD systems tend to live longer and possess more, sometimes up to 20 or 30 years old leads in their hearts, which causes a variety of complications.