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Premature Trigger of ERI in Medtronic EnRhythm Devices
Author(s) -
MIDDELDORP MELISSA E.,
MAHAJAN RAJIV,
ELLIOTT ADRIAN D.,
PATHAK RAJEEV K.,
TWOMEY DARRAGH,
WILSON LAUREN,
STOLCMAN SIMON,
MUNAWAR DIAN A.,
KUMAR SHARATH,
LAU DENNIS H.,
SANDERS PRASHANTHAN
Publication year - 2017
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/pace.13073
Subject(s) - medicine , pediatrics , emergency medicine
Background Medical technology has made significant advances over the last few decades with smaller and more dynamic pacemakers. However, technical failures leading to premature replacement is a cause of concern. We present a series of Medtronic EnRhythm devices that reached premature elective replacement indicator (ERI). Methods The database of Centre of Heart Rhythm Disorders was searched for EnRhythm device implantation from 2006 to 2011. Battery depletion <8.5 years was considered premature considering the projected average longevity to be 8.5–10.5 years. An unexpected premature ERI was defined when it was reached within 3 months of last normal check. Device follow‐up was conducted every 3 months after advisory. Results A total of 88 EnRhythm pacemakers were implanted. Over a median follow‐up of 6.2 years (range: 0.3–9.2), 39 (44.3%) EnRhythm devices reached premature ERI. In 11 (28%), ERI was not recognized and patients were being investigated for other causes of unsteadiness or dyspnea prior to device check. Notably, three (7%) patients had premature ERI < 3.5 years. Ten (25.6%) had sudden and unexpected premature ERI. While asynchronous pacing was observed, there were no cases of absence of pacing. Conclusions The rate of premature ERI for EnRhythm devices was 44.3%, significantly higher than reported by the manufacturer. Of concern, a sizeable proportion occurred unexpectedly, warranting more frequent reviews and empirical replacement in some patients. With the experience of the EnRhythm, appropriate monitoring strategies are recommended for future advisories.