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A case of riata® dual coil defibrillator lead failure in a patient with ventricular fibrillation.

Choi K, Kim JH, Kim HJ, Lee SO, Jang EY, Kim JS - Korean Circ J (2013)

Bottom Line: Chest radiography revealed a significant split in the insulation of the lead allowing the inner wire to protrude.We considered the removal of the failed lead, but the removal of ICD lead is potentially a high risk procedure, so we cut and capped a proximal part of the failed lead and inserted a new lead.This is the first report of a St. Jude Riata® dual coil defibrillator lead failure with clinical and radiologic evidence of a defect in lead insulation in Korea.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
A 50-year-old man, who underwent a procedure for an implantable cardioverter defibrillator (ICD), visited the outpatient department of our clinic after suffering multiple ICD shocks. The ICD interrogation revealed recurrent shock due to a high frequency of noise that is sensed by the device as ventricular fibrillation. Chest radiography revealed a significant split in the insulation of the lead allowing the inner wire to protrude. We considered the removal of the failed lead, but the removal of ICD lead is potentially a high risk procedure, so we cut and capped a proximal part of the failed lead and inserted a new lead. This is the first report of a St. Jude Riata® dual coil defibrillator lead failure with clinical and radiologic evidence of a defect in lead insulation in Korea.

No MeSH data available.


Related in: MedlinePlus

We cut and capped proximal part of failed lead and inserted new lead.
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Figure 4: We cut and capped proximal part of failed lead and inserted new lead.

Mentions: After 6 months of follow-up, routine chest radiography revealed a significant split in the insulation of the ICD lead allowing the inner wire to protrude (Fig. 3). He underwent a fluoroscopic evaluation for conductor external canalization. Before fluoroscopy, we considered removing the lead. But, we decided to leave a failed lead and insert a new ICD lead instead because of the high risk of complication during lead extraction. Under local anesthesia and fluoroscopic guidance, a previously inserted generator was removed and the proximal part of the old failed lead was cut and capped with encap®. A new single dual coil lead (DURATA® 7120Q/58, St. Jued Medical, Inc., St. Paul, MN, USA) with active fixation was inserted through the right subclavian vein and placed to the right ventricular mid-septum. After intraoperative measurements of pacing threshold, signal, and impedance, the lead was connected to a new single chamber generator (FORTIFY VR® CD1231-40Q, St. Jued Medical, Inc., St. Paul, MN, USA). The device and lead were placed appropriately in the preexisted ICD pocket site, which were verified via postoperative chest radiography (Fig. 4). He has been followed up regularly with no further episode of inappropriate shock via the outpatient department for 6 months.


A case of riata® dual coil defibrillator lead failure in a patient with ventricular fibrillation.

Choi K, Kim JH, Kim HJ, Lee SO, Jang EY, Kim JS - Korean Circ J (2013)

We cut and capped proximal part of failed lead and inserted new lead.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3675308&req=5

Figure 4: We cut and capped proximal part of failed lead and inserted new lead.
Mentions: After 6 months of follow-up, routine chest radiography revealed a significant split in the insulation of the ICD lead allowing the inner wire to protrude (Fig. 3). He underwent a fluoroscopic evaluation for conductor external canalization. Before fluoroscopy, we considered removing the lead. But, we decided to leave a failed lead and insert a new ICD lead instead because of the high risk of complication during lead extraction. Under local anesthesia and fluoroscopic guidance, a previously inserted generator was removed and the proximal part of the old failed lead was cut and capped with encap®. A new single dual coil lead (DURATA® 7120Q/58, St. Jued Medical, Inc., St. Paul, MN, USA) with active fixation was inserted through the right subclavian vein and placed to the right ventricular mid-septum. After intraoperative measurements of pacing threshold, signal, and impedance, the lead was connected to a new single chamber generator (FORTIFY VR® CD1231-40Q, St. Jued Medical, Inc., St. Paul, MN, USA). The device and lead were placed appropriately in the preexisted ICD pocket site, which were verified via postoperative chest radiography (Fig. 4). He has been followed up regularly with no further episode of inappropriate shock via the outpatient department for 6 months.

Bottom Line: Chest radiography revealed a significant split in the insulation of the lead allowing the inner wire to protrude.We considered the removal of the failed lead, but the removal of ICD lead is potentially a high risk procedure, so we cut and capped a proximal part of the failed lead and inserted a new lead.This is the first report of a St. Jude Riata® dual coil defibrillator lead failure with clinical and radiologic evidence of a defect in lead insulation in Korea.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT
A 50-year-old man, who underwent a procedure for an implantable cardioverter defibrillator (ICD), visited the outpatient department of our clinic after suffering multiple ICD shocks. The ICD interrogation revealed recurrent shock due to a high frequency of noise that is sensed by the device as ventricular fibrillation. Chest radiography revealed a significant split in the insulation of the lead allowing the inner wire to protrude. We considered the removal of the failed lead, but the removal of ICD lead is potentially a high risk procedure, so we cut and capped a proximal part of the failed lead and inserted a new lead. This is the first report of a St. Jude Riata® dual coil defibrillator lead failure with clinical and radiologic evidence of a defect in lead insulation in Korea.

No MeSH data available.


Related in: MedlinePlus