Combined use of a true-bipolar sensing implantable cardioverter defibrillator in a patient having a prior implantable spinal cord stimulator for intractable pain.
Reported is a case involving a patient with a previously implanted spinal cord stimulator (SCS) who presented for an implantable cardioverter defibrillator (ICD). The SCS device was located in the left lower abdominal quadrant with a stimulation electrode array placed on the dorsal aspect of the spinal cord at the T-11 thoracic level. Interaction testing demonstrated that the biopolar sensing transvenous ICD system (Medtronic 7221 Cx PCD) did not detect the stimulator's output at burst rates ranging from 20-130 pulses/s, even with the ICD set to its maximum sensitivity of 0.15 m V and the stimulator programmed to the highest patient tolerated output combinations of 5 V, 0.45 ms in the bipolar configuration and 3 V, 0.45 ms in the unipolar (i.e., case-electrode) configuration.
Monahan
K
K
Beth Israel/Deaconess Medical Center, Boston, Massachusetts 02215, USA.
Casavant
D
D
Rasmussen
C
C
Hallet
N
N
D000368:Aged; D002138:Calibration; D017147:Defibrillators, Implantable; D004558:Electric Stimulation / Q000295:instrumentation* / Q000379:methods*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D010148:Intractable Pain / Q000628:therapy*; D013116:Spinal Cord / Q000601:surgery*