title: A plea for delivery of high-voltage shocks during implantable cardioverter-defibrillator replacement or system upgrade.
abstract: We report the case of a faulty lead that led to failure to defibrillate during defibrillation threshold testing at the time of elective generator replacement. Standard lead measurements failed to detect the malfunction. Many centres perform neither defibrillation threshold testing nor commanded high-energy shock delivery. Even changes in the position of the lead in relation to the generator may cause problems that will go undetected without high-voltage shock delivery. We therefore caution against the wholesale abandonment of high-voltage shock testing in patients with pre-existing implanted leads.
authors.affiliation: Division of Cardiology, University Hospital Basel, Basel, Switzerland. csticherling@uhbs.ch
authors.forename: Christian
authors.initials: C
authors.lastname: Sticherling
authors.forename: Beat
authors.initials: B
authors.lastname: Schaer
authors.forename: Michael
authors.initials: M
authors.lastname: Kühne
authors.forename: Stefan
authors.initials: S
authors.lastname: Osswald
mesh_terms: D002311:Cardiomyopathy, Dilated / Q000628:therapy*; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D020878:Device Removal; D004554:Electric Countershock / Q000295:instrumentation / Q000379:methods*; D004868:Equipment Failure; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D019233:Retreatment; D018570:Risk Assessment; D016896:Treatment Outcome; D055815:Young Adult