Inside-Out Insulation Failure of a Defibrillator Lead with Abrasion-Resistant Coating Reply
Cedars Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA. Electronic address: .Heart rhythm: the official journal of the Heart Rhythm Society (Impact Factor: 4.92). 03/2013; 10(6). DOI: 10.1016/j.hrthm.2013.03.024
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ABSTRACT: Abrasion-induced insulation breach is a common failure mode of silicone-body, transvenous, implantable cardioverter defibrillator leads. It is caused either by external compression or internal motion of conducting cables. The present method of monitoring lead integrity measures low frequency conductor impedance. It cannot detect insulation failures until both the silicone lead body and inner fluoropolymer insulation have been breached completely, exposing conductors directly to blood or tissue. Thus the first clinical presentation may be either failure to deliver a life-saving shock or painful, inappropriate shocks in normal rhythm. We present a new method for identifying lead failure based on high frequency impedance measurements. This method was evaluated in 3D electromagnetic simulation and bench testing to identify insulation defects in the St. Jude Medical Riata® lead, which is prone to insulation breach.
Heart rhythm: the official journal of the Heart Rhythm Society 06/2014; 11(10). DOI:10.1016/j.hrthm.2014.06.015 · 4.92 Impact Factor
Circulation Arrhythmia and Electrophysiology 12/2014; 7(6):1237-61. DOI:10.1161/CIRCEP.114.002344 · 5.42 Impact Factor
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