title: Detection of insulation failure by gradual reduction in noninvasively measured electrogram amplitudes.
abstract: Insulation failure of pacemaker leads may give rise to functional defects such as under- or oversensing, loss of capture or muscle stimulation. An increased incidence of such failures has been reported for the bipolar polyurethane-insulated Medtronic model 6972 pacing lead. It is therefore important to identify techniques that will detect such insulation defects early. A case report is presented in which diminishing electrogram amplitude at follow-up predicted lead failure several months before becoming clinically manifest. This finding suggests that routine measurement of such an electrogram may be a useful tool in predicting impending lead malfunction.
mesh_terms: D000368:Aged; D001919:Bradycardia / Q000628:therapy; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D010138:Pacemaker, Artificial / Q000592:standards*