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Related Experiment Videos

[Inappropriate ICD shocks after collision with a pole].

Sing-Chien Yap1, Dominic A M J Theuns, Tamas Szili-Torok

  • 1Erasmus MC, afd. Cardiologie, Rotterdam.

Nederlands Tijdschrift Voor Geneeskunde
|March 17, 2016
PubMed
Summary

A patient received inappropriate implantable cardioverter-defibrillator (ICD) shocks due to lead fracture. Cine-fluoroscopy revealed the fracture, leading to lead extraction and system replacement.

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Area of Science:

  • Cardiology
  • Medical Device Technology
  • Diagnostic Imaging

Background:

  • Implantable cardioverter-defibrillators (ICDs) are crucial for managing life-threatening arrhythmias.
  • Lead integrity is essential for the proper functioning of ICD systems.
  • Lead fractures can lead to inappropriate shocks or failure to deliver therapy.

Observation:

  • A 60-year-old male experienced multiple inappropriate ICD shocks.
  • The patient's symptoms occurred after a physical collision.
  • Standard chest radiography did not clearly visualize the suspected lead issue.

Findings:

  • Cine-fluoroscopy identified a proximal lead fracture in the patient's ICD system.
  • The lead fracture was the cause of the inappropriate ICD shocks.
  • Surgical intervention was required to address the device malfunction.

Implications:

  • Cine-fluoroscopy is a valuable tool for diagnosing subtle lead fractures not apparent on radiography.
  • Prompt lead extraction and ICD system revision are necessary following lead fracture diagnosis.
  • This case highlights the importance of advanced imaging in troubleshooting ICD lead failures.

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