摘要
At present, malfunction of implantable cardioverter-defibrillator （ICD） lead has already gradually become a serious clinic problems for doctors,to well identify and manage the frequent inappropriate therapy induced by sensing abnormality due to pacing/sensing （P/S） lead malfunctions of ICD are another kind of challenge for cardiologists. Methods Lead malfunctions of ICD were identified during follow-up period, in which insulation layer rupture and lead fracture were the most frequent. Except for conventional examinations, events histories and pacing parameters were reviewed from electrogram of ICD to determine the causes of lead malfunctions and guide the management. Results Frequent inappropriate therapy induced by sensing abnormality due to P/S lead malfunctions （normal high-voltage part of ICD lead） was identified in five patients and successfully managed by simply implanting an additional P/S lead but keeping the original defibrillation lead （high-voltage part of the ICD lead）. Follow-up results showed that this method was safe and effective enough for these patients. Conclusions Inappropriate therapy induced by P/S lead malfunction could be well managed by only replacing P/S lead but keeping the normal original defibrillation lead, which could also greatly decrease the risk and medical cost than extracting original lead of ICD or adding a new defibrillation lead.
At present, malfunction of implantable cardioverter-defibrillator （ICD） lead has already gradually become a serious clinic problems for doctors,to well identify and manage the frequent inappropriate therapy induced by sensing abnormality due to pacing/sensing （P/S） lead malfunctions of ICD are another kind of challenge for cardiologists. Methods Lead malfunctions of ICD were identified during follow-up period, in which insulation layer rupture and lead fracture were the most frequent. Except for conventional examinations, events histories and pacing parameters were reviewed from electrogram of ICD to determine the causes of lead malfunctions and guide the management. Results Frequent inappropriate therapy induced by sensing abnormality due to P/S lead malfunctions （normal high-voltage part of ICD lead） was identified in five patients and successfully managed by simply implanting an additional P/S lead but keeping the original defibrillation lead （high-voltage part of the ICD lead）. Follow-up results showed that this method was safe and effective enough for these patients. Conclusions Inappropriate therapy induced by P/S lead malfunction could be well managed by only replacing P/S lead but keeping the normal original defibrillation lead, which could also greatly decrease the risk and medical cost than extracting original lead of ICD or adding a new defibrillation lead.
