Inappropriate sensing events revealing electrocautery-induced implantable cardioverter-defibrillator lead failure
Yükleniyor...
Dosyalar
Tarih
2015
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Electromagnetic interference (EMI) associated with current implantable cardioverter–defibrillator (ICD) generators and leads are less prone
to long-term failure. Thus, it has been suggested that routine post-ICD
replacement interrogation of the device may not be necessary. We present the case of a patient who underwent ICD replacement during which
therapies were inadvertently not turned off, which lead to EMI and shock
and subsequently lead failure.
A 52-year-old-man who had ICD (BiotronikLumax340 VR-T, Berlin,
Germany) implanted in 2008 presented with an ICD generator end-of-life
and was scheduled for generator replacement. Before the procedure
device interrogation showed a right ventricular (RV) pacing threshold of
0.6 V at 0.5 ms pulse width, R-wave sensing was 6.7 mV, RV lead pacing
impedance was 715 Ω, and shock impedance was 46 Ω. The patient
received a Medtronic D384DRG ICD, Minneapolis, USA. During the surgical closure of the device pocket, electrocautery was used for hemostasis, which resulted in EMI and inappropriate 35 J shock (Fig. 1).
Postoperatively, inappropriate senses were monitored, which were concordant with lead failure (Fig. 2). The RV pacing threshold increased to
1.25 V at 0.5 ms, and the R-wave sensing decreased to 3.30 mV. Lead
impedance measurements were RV pacing at 619 Ω, RV coil at 48 Ω, and
SVC coil at 73 Ω. At the second week, a new pace sense lead was
uneventfully implanted from the same site and over sense completely
ended after the replacement of the lead.
Despite the advances in ICD technology, electrocautery, especially
when used close to the device, can still lead to lead failure, which might
necessitate intervention. Thus, we still recommend routine postprocedural interrogation of the device.
Açıklama
WOS:000362968700030
Anahtar Kelimeler
Ekg
Kaynak
The Anatolian Journal of Cardiology
WoS Q Değeri
Scopus Q Değeri
Q3
Cilt
15
Sayı
10
Künye
Can, İ., Arıbaş, A., Dereli, Y., Tholakanalli, V. (2015). Inappropriate sensing events revealing electrocautery-induced implantable cardioverter-defibrillator lead failure. Anadolu Kardiyoloji Dergisi, 15, 10, E27-E27.
