Document Detail

Antitachycardia Pacing Therapy for the Successful Treatment of Lead Fracture.
MedLine Citation:
PMID:  25354719     Owner:  NLM     Status:  Publisher    
A 35-year-old man with non-ischemic cardiomyopathy underwent a single chamber implantable cardioverter defibrillator (ICD) implant with a St. Jude Medical Fortify VR pulse generator and an active fixation ventricular lead (St. Jude Durata model 7121, 65 cm) for the primary prevention of sudden cardiac arrest. Twenty months after device implant, he presented to our clinic for evaluation of a "funny sensation" in his chest. Device evaluation revealed ventricular sensing amplitude 2.4 mV, lead impedance 1500 ohms, and pacing capture threshold was 2.0 V @ 0.5 msec, which were all stable over the prior 6 months. The tachycardia detections were set for two zones: ventricular tachycardia (VT), 181-221 beats per minute (bpm), and ventricular fibrillation (VF), greater than 221 bpm. Antitachycardia pacing (ATP) therapies were programmed in both zones. In addition to several nonsustained VF events, there were two episodes of tachycardia in the VF zone, occurring on different days, for which ATP was delivered and noted to be successful (Figure 1). The figure shows electrical noise on the bipolar signal that was not seen on the far-field signal and did not correlate with any causes of external noise according to the patient. Interestingly, the noise disappeared instantly after ATP on both occasions. Though this phenomenon has been reported after some ICD shocks, the reasons have not been clarified. Polarization of the conductor allowing normal signal transmission is a possibility or a new position of the lead or patient as a result of the ICD therapy may explain the loss of lead noise. As a result, Figure 1 shows what appears to be effective therapy for lead fracture noise using ATP. Nonetheless, due to the diagnosis of lead fracture (without conductor externalization), he underwent successful right ventricular lead replacement. This article is protected by copyright. All rights reserved.
Ashish A Bhimani; Peerawut Deeprasertkul; Nischala Nannapaneni; George N Carayannopoulos
Related Documents :
18025529 - Myocardial expression of a dominant-negative form of daxx decreases infarct size and at...
15550529 - Long-term infusion of met5-enkephalin fails to protect murine hearts against ischemia-r...
2552189 - Calcium-activated neutral protease inhibitor (e-64c) and reperfusion for experimental m...
18716709 - Limitation of myocardial infarct size in the clinical setting: current status and chall...
2772179 - Reperfused and nonreperfused myocardial infarction: diagnostic potential of gd-dtpa--en...
18771549 - Evaluation cardioprotective effects of atorvastatin in rats by real time myocardial con...
17495229 - Effect of cell-based intercellular delivery of transcription factor gata4 on ischemic c...
10608589 - Acipimox does not augment thallium-201 redistribution in the fasting state.
2895129 - Balance among autonomic controls of heart rate in neonatal spontaneously hypertensive a...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-29
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-30     Completed Date:  -     Revised Date:  2014-10-31    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Food allergens inducing a lymphocyte-mediated immunological reaction in canine atopic-like dermatiti...
Next Document:  Significance of baseline bone markers on disease progression and survival in hormone-sensitive prost...