Respiratory rate trending as a cause for atrial lead noise: A first report in an implantable cardioverter-defibrillator patient

McClelland, Isla; Nayak, Hemal M.; Tung, Roderick; Upadhyay, Gaurav A.

doi:10.1016/j.hrcr.2018.08.007

Cited by 4 publications

(7 citation statements)

References 5 publications

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“…Boston Scientific ICDs use a subthreshold pulse of 80 μA to test pacing impedances. MV oversensing has been reported in a Boston Scientific ICD paired with an Abbott 1688 atrial lead; although impedance measurements were normal . Tanawuttiwat et al recently published a case series of patients with Medtronic Sprint Quattro Secure ICD leads paired with Boston Scientific ICDs with intermittent high impedance alerts.…”

Section: Discussionmentioning

confidence: 99%

High impedance alert with safety switching: An unreported hazard of hybrid pacing systems

Karnik

Helm

Gaskill

et al. 2019

Cardiovasc electrophysiol

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Several Boston Scientific pacemaker models have a known issue with intermittent oversensing of the minute ventilation sensor when paired with non-Boston Scientific leads. Several of our patients with these hybrid systems have had transient out of range impedances and oversensing after safety switching which we suspected may be related. A retrospective analysis of 395 patients who had pacemakers implanted between 2015-2017 found that transient out of range impedances with safety switching was present in 9% of Boston Scientific pacemakers paired with Abbott or Medtronic leads compared with 0% in other device-lead combinations (P = 0.0089).We postulate that the root cause of the minute ventilation oversensing and transient high impedance issue is the same, a header-lead interaction from low-level incompatibility. Recognizing this issue is critical to prevent unnecessary lead revisions or extractions as it can be prevented with a simple reprogramming of lead pace/sense configuration.

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Section: Discussionmentioning

confidence: 99%

High impedance alert with safety switching: An unreported hazard of hybrid pacing systems

Karnik

Helm

Gaskill

et al. 2019

Cardiovasc electrophysiol

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“…Despite all available leads and headers meeting international regulatory requirements, there have been reports in the literature documenting a higher rate of adverse device outcomes with mismatched systems. Case series have documented transient high‐impedance events in patients with a combination of a Boston Scientific ICD and either Medtronic or Abbott leads 1,2,4 . Recently, a large study of “hybrid” pacing systems incorporating Boston Scientific pacemakers and mismatched leads demonstrated a 9% rate of transient impedance increases 3 .…”

Section: Discussionmentioning

confidence: 99%

High‐impedance alerts with pulse generator—Lead mismatch

Christie

Tobgy

Seifer

et al. 2022

Journal of Arrhythmia

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Background Cardiac Implantable Electronic Devices (CIED) include pulse generators and leads. In some implanting centers, it is a common practice to combine devices with leads from different companies. Case series have reported episodic high‐impedance changes in Boston Scientific CIEDs with competitor leads. We investigated the incidence of high‐impedance abnormalities in matched versus mismatched Boston Scientific Accolade pacemakers. Methods A retrospective chart review identified all consecutive Boston Scientific Accolade pacemakers implanted between January 2017 and June 2019 at a Canadian tertiary care center. The primary outcome was the occurrence of transient, high‐impedance changes which resulted in a switch to unipolar pacing/sensing in the absence of any other identifiable lead issue. Fisher exact tests (two‐tailed, α = .05) were used to compare the incidence of outcomes in matched versus mismatched systems. Results 514 Boston Scientific Accolade pacemakers were associated with 882 individual leads. The primary outcome occurred with 21 leads (20 Medtronic and 1 Abbott), associated with occasional pacing inhibition, presyncope, and/or early surgical revision. Mismatched lead‐device pairs were significantly associated with CIED malfunction compared to matched lead‐device pairs (3.3% vs. 0%, p = .0019). The median time from implant to unipolar safety switch was 12.4 months. The median follow‐up time was 21.6 months. Conclusion Use of mismatched leads with a Boston Scientific Accolade device was associated with an increased risk of undesirable changes in sensing polarity with occasional inappropriate pacing inhibition. Awareness of this interaction can allow for the institution of appropriate programming remedies and may increase scrutiny of the use of mismatched CIED systems.

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“…Oversensing in cardiovascular implantable electronic devices (CIEDs) can be defined as sensing of signals that are not caused by local depolarizations and is often due to physiologic or non-physiologic causes [ 2 ]. Non-physiologic causes of oversensing, often referred to as noise, include electromagnetic interference (EMI), lead failure, lead-header connection problems, myopotentials, and sensing of extraneous pacemaker signals, such as those emitted by the minute ventilation sensor [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

Late presentation of recurrent syncope after permanent pacemaker implantation due to Lead−Header malapposition

Mazzone

Kohli

Aziz

et al. 2021

Indian Pacing and Electrophysiology Journal

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Permanent pacemaker (PPM) malfunction due to electrical connection problems such as a loose set screw or lead-header malapposition is extremely rare. We present a patient with complete heart block (CHB) who had PPM malfunction and recurrent syncope, late (14 months) after initial implantation, which was caused by the ventricular lead pin disengagement from the header resulting in oversensing due to noise, pacing inhibition and recurrent syncope. PPM due to lead-header malapposition this late after device implantation has previously not been reported.

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Respiratory rate trending as a cause for atrial lead noise: A first report in an implantable cardioverter-defibrillator patient

Cited by 4 publications

References 5 publications

High impedance alert with safety switching: An unreported hazard of hybrid pacing systems

High impedance alert with safety switching: An unreported hazard of hybrid pacing systems

High‐impedance alerts with pulse generator—Lead mismatch

Late presentation of recurrent syncope after permanent pacemaker implantation due to Lead−Header malapposition

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