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Sensing Failure Associated with the Medtronic Sprint Fidelis Defibrillator Lead
Author(s) -
KENIGSBERG DAVID N.,
MIRCHANDANI SUNIL,
DOVER AMANDA N.,
KOWALSKI MARCIN,
WOOD MARK A.,
SHEPARD RICHARD K.,
KALAHASTY GAUTHAM,
STEIN KENNETH M.,
MARKOWITZ STEVEN M.,
IWAI SEI,
SHAH BINDI K.,
LERMAN BRUCE B.,
MITTAL SUNEET,
ELLENBOGEN KENNETH A.
Publication year - 2008
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2007.01058.x
Subject(s) - medicine , lead (geology) , sprint , implant , implantable cardioverter defibrillator , cardiology , cardiac resynchronization therapy , surgery , heart failure , ejection fraction , physical therapy , geomorphology , geology
The diameter of implantable cardioverter‐defibrillator (ICD) leads has become progressively smaller over time. However, the long‐term performance characteristics of these smaller ICD leads are unknown. Methods: We retrospectively evaluated 357 patients who underwent implantation of a Medtronic Sprint Fidelis™ defibrillating lead at two separate centers between September 2004 and October 2006. Lead characteristics were measured at implant, at early follow‐up (1–4 days post implant), and every 3–6 months thereafter. Results: During the study period, 357 patients underwent implantation of the Medtronic Sprint Fidelis™ lead. The mean R‐wave measured at implant through the device was not different (P = NS) when compared with that measured at first follow‐up (10.5 ± 5.0 mV vs 10.7 ± 5.1 mV). Forty‐one patients (13%) had an R‐wave amplitude ≤ 5 mV measured through the device at implant. Of those patients with an R‐wave amplitude ≤ 5 mV at implant measured through the device, 63% (n = 26) remained ≤ 5 mV for the duration of follow‐up. The mean time to R‐wave amplitude ≤ 5 mV was 96.2 ± 123 days . During follow‐up, 65 (18%) patients developed R‐wave ≤ 5 mV. Overall 10 lead revisions (2.8%) were performed during the first year of follow‐up. Conclusion: Abnormal R‐wave sensing is frequently observed during follow‐up with the Medtronic Fidelis ICD lead. Lead revision was necessary in 2.8% of the patients, most often (8 of 10) due to abnormal R‐wave sensing along with elevated pacing threshold. Whether this issue is limited to this lead or reflects a potential problem with all downsized ICD leads merits further investigation.