Inappropriate Discharges of Intravenous Implantable Cardioverter Defibrillators Owing to Lead Failure

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Author(s)

    • Washizuka Takashi
    • Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences
    • Fujita Satoru
    • Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences
    • Okura Yuji
    • Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences
    • Aizawa Yoshifusa
    • Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences
    • Chinushi Masaomi
    • Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences
    • Kazama Ryu
    • Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences
    • Hirono Takashi
    • Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences
    • Watanabe Hiroshi
    • Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences
    • Komura Satoru
    • Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences
    • Sugiura Hirotaka
    • Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences
    • Tanabe Yasutaka
    • Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences
    • Furushima Hiroshi
    • Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences

Abstract

We describe here the case of a 58-year-old female patient who experienced inappropriate shocks from her implantable cardioverter-defibrillator (ICD). Stored electrograms from her ICD showed high frequency noise preceding the shock. Although the pacing threshold was normal and lead fracture was not found in chest X-rays, pacing lead impedance decreased to 480Ω. Moreover, such high frequency noise was observed by electrogram telemetry, but not by routine evaluation every 3 months. ICD lead dysfunction was suspected, so we elected to replace the ICD lead system. At the time of the operation, lead impedance was 410Ω and pacing threshold was the same as it was at the time of the ICD implantation, and no lead insulation disturbances were observed in the generator pocket. However, manipulation of the lead system produced high frequency noise reproducibly. Since some of the ICD lead dysfunction initially was clinically silent at rest, dysfunction was difficult to detect before serious problems occurred. Therefore, more careful evaluation of the ICD lead system is needed during long-term follow-up of ICD implants.<br>

Journal

  • International Heart Journal

    International Heart Journal 46(5), 909-913, 2005

    International Heart Journal Association

Codes

  • NII Article ID (NAID)
    130000068577
  • Text Lang
    ENG
  • ISSN
    1349-2365
  • Data Source
    J-STAGE 
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