Title

How Should Implantable Cardioverter-Defibrillator Lead Failures be Managed and What is the Role of Lead Extraction?

Document Type

Journal Article

Publication Date

6-1-2012

Journal

Cardiac Electrophysiology Clinics

Volume

4

Issue

2

DOI

10.1016/j.ccep.2012.02.009

Keywords

Defibrillator; Extraction; ICD; Lead failure; Management; Pacemaker

Abstract

Despite remarkable advances in design, implantable cardioverter-defibrillator (ICD) leads remain the component most susceptible to failure, which often leads to substantial adverse clinical outcomes. This article focuses on management strategies when ICD lead systems fail. Two cases involving management decisions for ICD lead failures are presented and discussed. One involves a common mode of presentation, inappropriate shocks. The second involves an alert in a patient with a complex system and multiple comorbidities. Although a systematic approach is outlined, management decisions must be balanced by a risk-and-benefit assessment of the individual patient. © 2012 Elsevier Inc.

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