Over a period of 8.5 years in 255 patients with full-system implantable cardioverter defibrillators, lead-specific complications requiring reoperation developed in 32 patients. A total of 36 leads were affected. Lead fracture was the cause of failure in half of these patients. Refinement and improvement in structural designs of these leads, use of endocardial leads, and attention to technical details during implantation should decrease the incidence of these complications.