期刊
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
卷 32, 期 5, 页码 1452-1457出版社
WILEY
DOI: 10.1111/jce.14994
关键词
electrode fracture; inappropriate ICD therapy; oversensing; subcutaneous ICD
This case report highlights an unexpected inappropriate shock due to a partial fracture of the S-ICD electrode, emphasizing the importance of awareness and systematic follow-up to prevent fatigue failure fractures. Recommendations for clinicians on systematic S-ICD follow-up and troubleshooting are discussed in the study.
The subcutaneous-implantable cardioverter-defibrillator (S-ICD) and its electrode were developed to avoid long-term complications of transvenous leads in the vasculature. We report a case of unexpected, inappropriate S-ICD shocks due to oversensing of high-amplitude, nonphysiologic, electrical noise artifacts that were not preceded by high-impedance alerts or sensing electrogram noise detections. Following explant, high-magnification X-ray imaging of the S-ICD electrode demonstrated partial fracture of the distal sensing conductor located near a short radius bend in the electrode at the electrode-header interface. Clinicians should be aware of a potential for fatigue failure fracture of the S-ICD electrode. Recommendations for systematic S-ICD follow-up and troubleshooting are discussed.
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