Downloadable Algorithm to Reduce Inappropriate Shocks Caused by Fractures of Implantable Cardioverter-Defibrillator Leads

• DOI: 10.1161/circulationaha.108.796136
• Publication Date: 2008-11-04T02:35:41Z
• Authors: Charles D. Swerdlow; Bruce D. Gunderson; Kevin T. Ousdigian; Athula Abeyratne; Robert W. Stadler; Jeffrey M. Gillberg; Amisha S. Patel; Kenneth A. Ellenb...
• Keywords: Lead (geology)

Background— The primary method for monitoring implantable cardioverter-defibrillator lead integrity is periodic measurement of impedance. Sprint Fidelis leads are prone to pace-sense fractures, which commonly present as inappropriate shocks caused by oversensing. Methods and Results— We developed tested an algorithm enhance early identification fractures reduce shocks. This lead-integrity algorithm, can be downloaded into presently implanted cardioverter-defibrillators, alerts the patient and/or physician when triggered either oversensing or excessive increases in To shocks, number intervals detect (NID) ventricular fibrillation triggered. was on data from 15 970 patients with (including 121 clinically diagnosed fractures) 95 other fractured confirmed analysis returned product. effect NID 92 927 fracture. Increasing reduced ( P <0.0001). provided at least a 3-day warning 76% (95% CI, 66 84) versus 55% 43 64) optimal impedance =0.007). Its positive predictive value 72% 81% header-connector problems requiring surgical intervention. false-positive rate 1 per 372 patient-years monitoring. Conclusions— A download existing cardioverter-defibrillators short-term reduces likelihood It first downloadable RAMware performance nominally functioning feature that triggers real-time changes detection parameters