Unusual fracture in a Durata lead with shock coil fragmentation and cable externalization

Sato, Toshiaki; Soejima, Kyoko; Yoshino, Hideaki; Shoda, Morio

doi:10.1016/j.hrcr.2017.03.006

Cited by 3 publications

(4 citation statements)

References 11 publications

(16 reference statements)

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“…At this time point, the outer polyurethane insulation of the pacing lead decreased in thickness but not entirely breached. The damage to the ICD lead was likely similar to the scenario presented by Sato et al, 1 in which the shock coil was completely fractured if that case had been interrupted at an earlier stage ( Figure 1 , top right). However, the number of in vitro sliding cycles was likely much lower than the number required in vivo for a clinical presentation of lead malfunction, usually tens to hundreds of million, equivalent to months or years.…”

supporting

confidence: 58%

“…The interaction between 2 leads is one of the few mechanisms that may cause damage to both insulation and conductors and could ultimately cause loss of therapy. 1 , 2 The general guidance is to avoid contact between leads, which can be challenging. However, there is limited information about the time progression of damage and factors that may influence which lead is damaged.…”

mentioning

confidence: 99%

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Mechanisms of damage related to ICD and pacemaker lead interaction

Pokharel,

Mahajan,

Himes

et al. 2023

Heart Rhythm O2

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supporting

confidence: 58%

mentioning

confidence: 99%

Mechanisms of damage related to ICD and pacemaker lead interaction

Pokharel,

Mahajan,

Himes

et al. 2023

Heart Rhythm O2

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“…The Durata lead is less susceptible to "inside-out" insulation failure than the previous Riata and Riata ST leads. The Optim coating might prevent exteriorized cables, and it provides a 50-fold increase in abrasion resistance compared with silicone [5,6]. However, an Achilles heel of the Durata lead is the underside of the shock coil, which is not covered with Optim, although the most recent Optisure lead (Abbott) is completely covered with Optim.…”

Section: Discussionmentioning

confidence: 99%

Defibrillation failure with short ICD charge time: Internal short circuit of a Durata lead

Okada

Shoin

Shoda

et al. 2020

Journal of Cardiology Cases

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A 17-year-old male with hypertrophic cardiomyopathy underwent placement of a dual-chamber implantable cardioverter defibrillator (ICD) in 2010. In October 2016, he suffered a cardiac arrest. His ICD was interrogated after visiting our hospital. The shock failed, and ventricular fibrillation (VF) terminated spontaneously to sinus rhythm. The Durata lead (SJM, Sylmar, CA, USA) was removed for investigation. The lead had an internal abrasion of a right ventricular conductor cable at the superior vena cava coil. These findings suggest that the ICD shocks that failed to terminate the VF were delivered with low energy due to an internal short circuit of the Durata lead. The very short charge time indicates insufficient energy delivery, which may cause failure of cardioversion and defibrillation.

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“…Conductor cable externalization (CCE) is usually the result of inside-out abrasion (IOA) and may be associated with electrical malfunction. This distinct mode of insulation damage has been associated with defibrillator leads with symmetric conductor cable lumen distribution,1, 2, 3, 4, 5 although it has also been observed in defibrillator leads with asymmetric cable lumen distribution 6 . We report the first case of CCE in a multilumen atrial hemodynamic sensor lead: the SonRtip atrial lead (MicroPort, Shanghai, China).…”

Section: Introductionmentioning

confidence: 95%