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Subcutaneous implantable cardioverter‐defibrillator electrode fracture: Follow‐up, troubleshooting, and evaluation
Author(s) -
Kella Danesh K.,
Stambler Bruce S.
Publication year - 2021
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/jce.14994
Subject(s) - medicine , troubleshooting , electrode , implantable cardioverter defibrillator , cardiology , biomedical engineering , reliability engineering , chemistry , engineering
The subcutaneous‐implantable cardioverter‐defibrillator (S‐ICD) and its electrode were developed to avoid long‐term complications of transvenous leads in the vasculature. We report a case of unexpected, inappropriate S‐ICD shocks due to oversensing of high‐amplitude, nonphysiologic, electrical noise artifacts that were not preceded by high‐impedance alerts or sensing electrogram noise detections. Following explant, high‐magnification X‐ray imaging of the S‐ICD electrode demonstrated partial fracture of the distal sensing conductor located near a short radius bend in the electrode at the electrode‐header interface. Clinicians should be aware of a potential for fatigue failure fracture of the S‐ICD electrode. Recommendations for systematic S‐ICD follow‐up and troubleshooting are discussed.