title: Insulation damage in a shock wire: an unexpected fluoroscopic image.
abstract: We report on a patient with a single-chamber implantable cardioverter defibrillator admitted with an increase in high-voltage lead impedance, detected with home-monitoring, and inappropriate shocks due to noise on the electrogram. Chest x-ray revealed no abnormalities. Fluoroscopy before the revision procedure showed insulation failure with migration of the shock wire in the heart. The lead was removed and replaced with a new shock lead. This is, as far as we know, the first report on such a particular insulation failure, detected with home-monitoring and inappropriate shocks.
authors.affiliation: Department of Electrophysiology, Thorax Center, Erasmus Medical Center, Rotterdam, The Netherlands. s.valk@erasmusmc.ml
authors.forename: Suzanne
authors.initials: S
authors.lastname: Valk
authors.forename: Ronald
authors.initials: R
authors.lastname: Luijten
authors.forename: Luc
authors.initials: L
authors.lastname: Jordaens
mesh_terms: D017147:Defibrillators, Implantable; D004868:Equipment Failure; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*