EDITORIAL Need for real-world data on management of the (potentially) failing lead

This editorial refers to ‘Management of recalled implanta-ble cardioverter-defibrillator leads at generator replace-ment: a decision analysis model for Fidelis leads ’ by H. Burri and C. Combescure, on page 1210. Pacemaker and implantable cardioverter-defibrillator (ICD) therapy have had many successful years with extended indications, lower costs, and prolonged patient survival leading to a continuously growing population of patients with a cardiovascular implantable electronic device (CIED). Despite the fact that the device may present random and systematic failures, the lead connecting the CIED with the heart has turned out to be the ‘weakest link ’ in CIED systems.1 The history has shown a series of mistakes in design and engineering giving rise to smaller enclaves of affected patients, e.g. the J-shaped Teletronics Accufix atrial lead. However, it is the combination of the surge in using ICDs fo