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Diagnostic Approach to Suspected Lead Failure
Anand Thiyagarajah1, Marc Strik2, Sylvain Ploux2
1Department of Cardiology, University of Adelaide and Royal Adelaide Hospital, Port Road, Adelaide, SA 5000, Australia; CHU de Bordeaux, service de Cardiologie-électrophysiologie et stimulation cardiaque, INSERM, U 1045, Bordeaux F-33000, France; Department of Cardiology-Electrophysiology and Cardiac Pacing, Univ. Bordeaux, INSERM, CRCTB, U 1045, IHU Liryc, Bordeaux F-33000, France.
Abstract:
Transvenous lead failure associated with cardiac pacing and defibrillation remains an important clinical problem, with an estimated incidence between 1 to 2%. Oversensing of non-physiological signals usually precede lead impedance changes and may result in clinical compliations such as pacing inhibition and inappropriate shocks. Device based algorithms that identify non-physiological signals can be used in conjunction with remote monitoring to facilitate early diagnosis and management of lead failure and avoid serious adverse outcomes. This review highlights mechanisms of lead failure and proposes a diagnostic approach to suspected lead failure.
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