Limitations of the DF-4 Defibrillator Connector Necessitating Device Removal


  • Disclosure of Financial Support:

  • Cogert: None.

  • Cameron: Non-significant honoraria from Boston Scientific, Medtronic, and St. Jude Medical.

  • Sandler: Advisory board St. Jude Medical and Boston Scientific. Event review committee Medtronic.

Address for reprints: Gregory Cogert, M.D., 1265 South Utica Ave., Tulsa, OK, 74104. Fax: (918) 592-1021; e-mail:


The DF-4 implantable defibrillator connector was recently released for clinical practice. This connector facilitates lead to device connection, reduces bulk in the device pocket, and eliminates the risk of incorrect device connection. Unfortunately, new technology often introduces new challenges. We report the case of a 63-year-old male with chronic systolic heart failure referred for cardiac resynchronization therapy-defibrillator implant. Limitations implicit to the current iteration of this technology include a lack of additional connectivity. In the present case, these limitations ultimately warranted device removal and reimplant with a traditional trifurcating IS-1/DF-1 connector. (PACE 2012; 35:e24–e26)