Premature ICD battery depletion due to a defective lead adapter component: usefulness of extensive data logging

Described herein is the usefulness of extensive data logging of third generation ICDs in a patient with premature ICD battery depletion due to a defective pace/sensing lead component. Due to noise artifacts, VT/VF detections occurred leading to inappropriate patient shock discharges and 2,267 internal charge dumps within 2 weeks. During manual manipulations at the ICD site, real-time intracardiac electrocardiogram and event markers revealed noise artifacts that were interpreted as VT/VF. Radiography confirmed slight movement of the pace/sensing lead pin out of the Y-adapter. Therefore, the design of adapter systems without screw fixation should be reviewed to ensure lead integrity. In the case of sudden increases in VT/VF recognition, defective sensing components must be considered.