Lead noise with an active-fixation defibrillation lead.

Area of Science:

• Cardiology
• Biomedical Engineering

Background:

• Inappropriate detection and therapy are common adverse events in implantable cardioverter defibrillator (ICD) therapy.
• Lead artifact, often presenting late due to lead component stress, is a known mechanism for these inappropriate events.

Observation:

• This study describes experience with Endotak Endurance EZ leads (Models 0154/0155/0156).
• Of 20 implants, four patients exhibited noise leading to inappropriate detections in three.
• No patient received therapy due to these detections.

Findings:

• The artifact appeared early post-implant and resolved in three of four affected patients by four weeks.
• No noise developed in the remaining 16 patients after this initial period.
• This specific lead problem is unique in its transient nature.

Implications:

• While resolving over time, this lead artifact can still cause inappropriate therapies and management challenges.
• Careful monitoring is needed, especially in high-risk patients with ventricular arrhythmias.
• Understanding lead behavior is crucial for optimizing ICD therapy safety and efficacy.