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Limitation of Programmed Alerts to Predict ICD Lead Failures
Author(s) -
VLAY STEPHEN C.
Publication year - 2009
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2009.02321.x
Subject(s) - medicine , lead (geology) , implantable cardioverter defibrillator , cardiology , medical emergency , emergency medicine , geology , geomorphology
A 75‐year‐old man with a Sprint Fidelis ICD lead (Medtronic Inc., Minneapolis, MN, USA) experienced inappropriate shocks after sudden failure of the right ventricular (RV) pace‐sense connector resulting in noise. Interrogation of the implantable cardioverter‐defibrillator pulse generator revealed that the 3 AM daily measurement of RV pacing impedance was slightly higher (750 Ω) than the baseline (∼450–550 Ω )(although below the recommended alert level of 1,000 Ω ) and markedly higher at 4 AM (1,552 Ω ) when therapies were delivered. The event occurred before the patient could be alerted by the audible tones. Thus, the manufacturer's recommended impedance monitoring alert parameters will not predict all lead failures .