Nonphysiologic noise early after defibrillator implantation in Canada: incidence and implications: a report from the Canadian Heart Rhythm Society Device Committee.
BACKGROUND
Following recent cases of nonphysiologic noise noted early after defibrillator implantation, the Canadian Heart Rhythm Society Device Committee decided to evaluate the implications of this problem.


OBJECTIVE
To determine the incidence and consequences of nonphysiologic noise early after defibrillator implantation.


METHODS
The Canadian Heart Rhythm Society Device Committee surveyed all Canadian defibrillator implanting centers regarding their implant volumes and number of cases where nonphysiologic noise had been noted early (< 24 hours) after implant over the preceding 2 years. For such cases, information regarding the manufacturer and occurrence of inappropriate shock or inhibition of pacing was reported.


RESULTS
Responses were obtained from 20 of 23 surveyed implanting centers, with a total implant volume of 4960 defibrillators per year. The occurrence of nonphysiologic noise early after implantation was noted in 25 cases over the preceding 2 years (0.25%). Noise was detected in devices of all 3 of the leading volume device manufacturers. There were 2 cases of inappropriate shocks and 2 cases of symptomatic pacing inhibition. In 4 cases, removal of the lead from the header and retesting with the analyzer confirmed normal lead function. In all cases, the noise resolved within 24 hours.


CONCLUSIONS
Nonphysiologic noise early after defibrillator implantation was noted in 0.25% of procedures and was not limited to one specific manufacturer. This noise may result in an inappropriate shock or inhibition of pacing in a pacemaker-dependent patient. This transient phenomenon, possibly related to fluid and/or air in the header, appears to always resolve without surgical intervention.
McGill University Health Center, Montreal, Quebec, Canada. vidal.essebag@mcgill.ca
Vidal
V
Essebag
Jean
J
Champagne
David H
DH
Birnie
Atul
A
Verma
Jeffrey S
JS
Healey
Christopher S
CS
Simpson
Teresa
T
Kus
Bernard
B
Thibault
Iqwal
I
Mangat
Stanley
S
Tung
Laurence
L
Sterns
Derek V
DV
Exner
Ted
T
Davies
Benoit
B
Coutu
Eugene
E
Crystal
Elizabeth A
EA
Stephenson
Sean
S
Connors
Felix Ayala
FA
Paredes
Ratika
R
Parkash
Andrew D
AD
Krahn
D002170:Canada; D002304:Cardiac Pacing, Artificial / Q000379:methods / Q000706:statistics & numerical data; D017147:Defibrillators, Implantable / Q000009:adverse effects / Q000592:standards; D004554:Electric Countershock / Q000706:statistics & numerical data; D004560:Electricity / Q000009:adverse effects*; D004868:Equipment Failure / Q000706:statistics & numerical data; D019544:Equipment Failure Analysis / Q000706:statistics & numerical data; D004869:Equipment Safety / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged