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Lead and implantable cardioverter defibrillator (ICD) device failure is a severe problem in ICD therapy and may occur without preceding signs of deterioration. Insulation lead failure and subsequent ICD defect 7 months after ICD implantation for secondary prevention of sudden cardiac death (SCD) in a 70-year-old male was automatically detected with the Home Monitoring system. Immediate lead and device replacement was performed. This case illustrates the benefit of permanent automatic remote monitoring of implanted active devices.

Early automatic remote detection of combined lead insulation defect and ICD damage