1. Sylvain Ploux et al. JACEP 2017;3:315-328
Lead Fracture Identified Through the Medtronic LIA Lead warning transmitted as a red CareAlert from a Medtronic Secura DR implanted in secondary prevention in The observation folder contains a Lead Integrity Warning related to the association of NSVT and short VV intervals (red arrows). The ICD lead impedances were normal and stable. The recorded EGMs evoke a lead fracture (part of an EGM containing noise is shown at the bottom). This alert allows early identification of conductor fracture, as well as insulation failure, and therefore reduces the incidence of inappropriate shocks. Note that the alert was transmitted at 10:08 pm, as soon as the device has found the transmitter (direct transmission). Confronted with the same technical issue, the 3 Biotronik, Boston Scientific, and LivaNova systems would have remained silent. AF = atrial fibrillation; AT = atrial tachycardia; bpm = beats per minute; EGM = electrogram; FVT = fast ventricular tachycardia; ICD = implantable cardioverter-defibrillator; LIA = lead integrity alert; MVP = managed ventricular pacing; NSVT/VT-NS = nonsustained ventricular tachycardia; RV = right ventricular; SVT = supraventricular tachycardia; V = ventricular; VF = ventricular fibrillation; VP = ventricular pacing; VT = ventricular tachycardia; VT-NS = nonsustained ventricular tachycardia.
Sylvain Ploux et al. JACEP 2017;3:
2017 American College of Cardiology Foundation