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Unrecognized Failure of a Narrow Caliber Defibrillation Lead: The Role of Defibrillation Threshold Testing in Identifying an Unprotected Individual

Authors

  • DARRYL P. LEONG M.B.B.S., M.P.H., Ph.D.,

    1. Department of Cardiology, Leiden University Medical Centre, Leiden, the Netherlands
    2. Discipline of Medicine, University of Adelaide, Adelaide, Australia
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  • LIESELOT VAN ERVEN M.D., Ph.D.

    1. Department of Cardiology, Leiden University Medical Centre, Leiden, the Netherlands
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  • Financial Support: Dr. Leong is supported by the National Heart Foundation of Australia, the National Health and Medical Research Council of Australia, and the Royal Australasian College of Physicians.

Address for reprints: Lieselot van Erven, M.D., Ph.D., Department of Cardiology, Leiden University Medical Centre, Albinusdreef 2 2333ZA Leiden, the Netherlands. Fax: 31 71 526 6809; e-mail: L.van_Erven@lumc.nl

Abstract

In this case report we describe a short circuit in the Riata 1570 defibrillator lead (Riata 1570, St. Jude Medical, St. Paul, MN, USA) that was unsuspected owing to normal lead parameters until defibrillator threshold testing at the time of elective generator change. On this occasion, the short circuit manifested as unsuccessful defibrillation of ventricular fibrillation with immediate battery depletion. This report adds weight to existing concerns over narrow caliber leads, it draws attention to the possibility of lead malfunction despite unremarkable interrogation, and lastly it highlights the potential role of routine defibrillator threshold testing, particularly at elective generator change (an issue that remains sparingly addressed in the existing literature). (PACE 2012; 35:e154–e155)

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