Limitation of Programmed Alerts to Predict ICD Lead Failures |
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| Authors: | STEPHEN C. VLAY M.D. |
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| Affiliation: | From the Stony Brook Arrhythmia Study and Sudden Death Prevention Center, Division of Cardiology, Department of Medicine, Stony Brook University, Stony Brook, New York |
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| Abstract: | 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 . |
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| Keywords: | defibrillation—ICD ICD lead failure Sprint Fidelis |
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