Diagnosis of ICD lead failure using continuous event marker recording.
Stored electrograms enhance the ability to evaluate therapy episodes in the third-generation implantable cardioverter defibrillator. These electrograms are recorded from either the shocking or rate sensing leads, but not both. As a result, differentiation of certain types of sensing abnormalities may be difficult prior to surgical exploration. We present a case of rate sensing lead failure due to an insulation break. Several minutes of recording of the event marker in the laboratory failed to document any abnormal sensing; the diagnosis was made by recording the event marker on a 24-hour continuous (Holter) monitor. The Holter monitor/event marker combination was of substantial diagnostic value and allowed for a more focused surgical evaluation and treatment.
Horton
R P
RP
Department of Medicine, UT Southwestern Medical Center, Dallas, Texas 75235-9047, USA.
Canby
R C
RC
Román
C A
CA
Jessen
M E
ME
Schulte
T J
TJ
Page
R L
RL
D017147:Defibrillators, Implantable; D015716:Electrocardiography, Ambulatory; D004567:Electrodes, Implanted; D004867:Equipment Design; D004868:Equipment Failure; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000628:therapy