Sensing Lead Failure in Implantable Defibrillators:

Degeratu, Florin T.; Khalighi, Koroush; Peters, Robert W.; Shorofsky, Stephen R.; Gold, Michael R.

doi:10.1111/j.1540-8167.2000.tb00730.x

Cited by 33 publications

(17 citation statements)

References 14 publications

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“…The implantable cardioverter‐defibrillator (ICD) has become standard therapy for patients with life‐threatening or potentially life‐threatening ventricular tachyarrhythmias 1,2 . However, despite increasing numbers of implants, ICD lead reliability continues to be an important clinical problem 3–7 . Lead failure can have a variety of clinical consequences, the most common being delivery of inappropriate shocks (IS) during sinus rhythm due to oversensing of make‐brake potentials.…”

Section: Introductionmentioning

confidence: 99%

Inappropriate Shocks in Patients With Fidelis® Lead Fractures: Impact of Remote Monitoring and the Lead Integrity Algorithm

Blanck

Axtell

Brodhagen

et al. 2011

Journal of Cardiovascular Electrophysiology

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This study confirms that LIA significantly decreases IS therapy in patients with Fidelis lead fractures. Wireless technology enhances LIA benefits by significantly shortening time to reprogram defibrillators. However, despite the "best scenario" of combining LIA and wireless monitoring, 14% of patients with lead fractures still get IS. Further refinements of detection algorithms are required to eliminate this significant clinical problem.

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Section: Introductionmentioning

confidence: 99%

Inappropriate Shocks in Patients With Fidelis® Lead Fractures: Impact of Remote Monitoring and the Lead Integrity Algorithm

Blanck

Axtell

Brodhagen

et al. 2011

Journal of Cardiovascular Electrophysiology

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“…Dedicated bipolar ventricular leads (tip‐ring sensing) were thought less prone to ventricular oversensing than integrated bipolar leads (tip‐distal coil sensing). In a direct comparison of the two leads, there was more inappropriate arrhythmia detection (due to lead failure) with dedicated bipolar leads, than with integrated bipolar leads (17.8% vs. 4.3%) 13 …”

Section: Discussionmentioning

confidence: 98%

T‐Wave Oversensing in Implantable Cardiac Defibrillators Is Due to Technical Failure of Device Sensing

Gilliam

2006

Cardiovasc electrophysiol

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The expanded indications for the use of implantable cardioverter defibrillators (ICDs) for primary prevention of sudden cardiac death have increased concerns about inappropriate delivery of therapies. Dual-chamber systems have improved the capacity of ICDs to differentiate ventricular arrhythmias from supraventricular arrhythmias. Still, T-wave oversensing is a major source of inappropriate therapy. It is likely the true incidence of T-wave oversensing is greater than reported as documented events reflect only those stored in a device memory. Reviewing cases of T-wave oversensing that failed noninvasive correction; we found successful resolution resulted from generator replacement. We conclude that T-wave oversensing is due to inadequate signal processing by some ICD generators.

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“…In a direct comparison of the 2 leads, Degeratu et al reported that there were more inappropriate arrhythmia detection (because of lead failure) with dedicated bipolar leads than with integrated bipolar leads (17.8% versus 4.3%). 16 Nevertheless, Freedman et al 17 in a study with 292 patients who were randomly assigned to receive dedicated or integrated bipolar RV leads at the time of cardiac resynchronization therapy-defibrillator implantation reported that integrated bipolar RV defibrillator leads had a significantly lower incidence of RV anodal stimulation when compared with dedicated bipolar RV defibrillation leads, but with no clinically detectable oversensing or undersensing, and with no inappropriate ventricular tachyarrhythmia detections for either lead type. Whether sensing configuration has any relevance in patients with BrS has not been specifically evaluated.…”

Section: Discussionmentioning

confidence: 99%

T-Wave Oversensing in Patients With Brugada Syndrome: True Bipolar Versus Integrated Bipolar Implantable Cardioverter Defibrillator Leads

Rodríguez‐Mañero

Asmundis

Sacher

et al. 2015

Circ: Arrhythmia and Electrophysiology

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Background-It is thought that dedicated bipolar are more susceptible to T-wave oversensing when compared with integrated bipolar leads. This could be of extreme importance in patients with Brugada syndrome (BrS) because T-wave oversensing in this population is more frequent when compared with other implantable cardioverter defibrillator (ICD) recipients without BrS. We aimed to compare the incidence of T-wave oversensing in patients with BrS according to the type of lead (integrated bipolar versus true/dedicated bipolar). Methods and Results-All patients diagnosed with BrS with an ICD implant in 10 tertiary hospitals between 1993 and 2013were included in the study. A total of 480 patients were included (mean age, 45.6±14 years). During a mean follow-up of 74.9±51.7 months (median, 69; range, 2-236), 28 patients had T-wave oversensing (5.8%), leading to inappropriate shock in 18 (3.8%). All these events occurred in patients with true bipolar ICD leads (P=0.01) and in 2 patients it was solved instantaneously by changing the configuration from a dedicated to an integrated bipolar sensing configuration. In the stepwise multivariate models, only integrated bipolar ICD leads (hazard ratio, 0.34; 95% confidence interval, 0.171-0.675; P=0.002) was independent predictor of non-T-wave oversensing. Conclusions-T-wave oversensing is a potential reason of inappropriate shocks in patients with BrS receiving ICDs. In the vast majority it can be solved by reprogramming. However, in some patients it still requires invasive intervention. Importantly, incidence is significantly lower using an integrated bipolar lead system when compared with a dedicated bipolar lead system and hence the latter should be routinely used in BrS cases. Rodríguez-Mañero et al T-Wave Oversensing in Brugada Syndrome 793oversensing when compared with integrated bipolar leads, probably because of greater variations in R-wave amplitude. 3,4 This could be of extreme importance in BrS because T-wave oversensing in this population has been reported to be more frequent. 5We aimed to compare the incidence of T-wave oversensing in patients with BrS according to the type of ICD lead (integrated bipolar [coil plus distal lead electrode] versus dedicated bipolar). MethodsAll patients diagnosed with BrS and implanted with an ICD in 10 tertiary hospitals between 1993 and 2013 were included in the study. The diagnosis was made after an episode of aborted sudden cardiac arrest, during evaluation of syncope, in asymptomatic patients with a suggestive ECG pattern recorded during routine examination, or as a consequence of familial screening after the diagnosis of BrS in a family member. This registry was approved by the institutional review committee, and the subjects gave informed consent.Patients were included in the study if they had a type 1 Brugada pattern on ECG at baseline on at least 1 occasion or after provocation with a class I antiarrhythmic drug (determined by its availability in the participating hospitals; ajmaline, pilsicainide, flecainide, or procainamida...

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Sensing Lead Failure in Implantable Defibrillators:

Cited by 33 publications

References 14 publications

Inappropriate Shocks in Patients With Fidelis® Lead Fractures: Impact of Remote Monitoring and the Lead Integrity Algorithm

Inappropriate Shocks in Patients With Fidelis® Lead Fractures: Impact of Remote Monitoring and the Lead Integrity Algorithm

T‐Wave Oversensing in Implantable Cardiac Defibrillators Is Due to Technical Failure of Device Sensing

T-Wave Oversensing in Patients With Brugada Syndrome: True Bipolar Versus Integrated Bipolar Implantable Cardioverter Defibrillator Leads

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