NASPE POLICY STATEMENT The NASPE* BPEG** Defibrillator Code

BERNSTEIN, A.D., et al .: The NASPE/BPEG Defibrillator Code. A new generic code, patterned after and compatible with the NASPE/BPEG Generic Pacemaker Code (NBG Code) was adopted by the NASPE Board of Trustees on January 23, 1993. It was developed by the NASPE Mode Code Committee, including members of the North American Society of Pacing and Electrophysiology (NASPE) and the British Pacing and Electrophysiology Group (BPEG). It is abbreviated as the NBD (for NASPE/BPEG Defibrillator) Code. It is intended for describing the capabilities and operation of implanted cardioverter defibrillators (ICDs) in conversation, record keeping, and device labeling, and incorporates four positions designating: (1) shock location; (2) antitachycardia pacing location; (3) means of tachycardia detection; and (4) antibradycardia pacing location. An additional Short Form, intended only for use in conversation, was defined as a concise means of distinguishing devices capable of shock alone, shock plus antibradycardia pacing, and shock plus antitachycardia and antibradycardia pacing. (PACE, Vol. 16, September 1993)     

Accuracy at radiography and probing for the diagnosis of proximal caries

In 63 teenagers the proximal surfaces of premolars to be extracted for orthodontic reasons and the adjacent surfaces of neighboring teeth, 598 surfaces in all, were examined radiographically and by probing. Direct inspection after extraction revealed that 51% of the surfaces had incipient carious lesions and 5% lesions with cavities. Of the surfaces with cavities 82.1% were correctly diagnosed radiographically if any radiolucency, regardless of its extent, was used as a diagnostic criterion. However, this yielded a false positive rate of 19.6%. If only radioluccncies extending at least into the inner third of the enamel were called positive the true positive rate was 36.7% and the associated false positive rate 1.6%. At a 5% cavity frequency the predictive positive values were 17% and 53%, respectively. Probing yielded a true positive rate of about 29% and a false positive rate of 1.1% with a predictive positive value of 50-57%. All radiolucencies extending into the dentin were associated with cavities. When the most liberal radiographic criterion was used 37.5% of all carious lesions, whether associated with a cavity or not, were detected and 3.8% of sound surfaces were falsely called carious. The corresponding predictive positive value at the actual rate of incipient lesions and lesions with cavities was 92.6%.     

Corrosion of Pacemaker Electrodes

As improvements in pacemaker components and design increase pacemaker life, problems with other components may emerge such as corrosion of the electrodes. Explanted electrodes were examined under a scanning electron microscope and the degree of corrosion was graded and correlated with the reasons for expiantation, the status of the explanted pacemaker, and the duration of the implant. Fifty-six explanted electrodes were removed for loss of capture or sensing, pacemaker extrusion, broken wires, or after death. A numerical grading system was used to qualitate the degree of corrosion. The pacemaker itself was retrieved in 50 cases, permitting evaluation of the entire pacing system. The dc component of the pacemaker output was measured. Without She aid of magnification most electrodes appeared shiny and smooth. With one exception all corrosion was microscopic. Significant corrosion was seen on all pacemaker electrodes that had been connected to pacemakers with dc offset currents greater than 5 microamperes. All except the "youngest" explanted electrode showed some degree of corrosion. The data suggest that corrosion was directly related to the duration of implantation. With the possible exception of one case, no consistent adverse clinical effects were observed, even when electrodes were heavily corroded. Whether or not corrosion eventually will progress to the point that clinical problems become manifest cannot be predicted at this time.