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Subcutaneous Implantable Cardioverter Defibrillator (S-ICD) Electrode Fracture: Follow-up, Troubleshooting and Evaluation
  • Danesh Kella,
  • Bruce Stambler
Danesh Kella
Mayo Clinic
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Bruce Stambler
Piedmont Heart Institute
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Abstract

Introduction: The subcutaneous-ICD (S-ICD) and its electrode were developed to avoid long-term complications of transvenous leads in the vasculature. Methods: We report a case of unexpected, inappropriate S-ICD shocks due to oversensing of high amplitude, non-physiologic, electrical noise artifacts that were not preceded by high impedance alerts or sensing electrogram noise detections. Results: Following explant, high-magnification, X-ray imaging of the S-ICD electrode demonstrated partial fracture of the distal sensing conductor located near a short radius bend in the electrode at the electrode-header interface. Conclusions: Clinicians should be aware of a potential for fatigue failure fracture of the S-ICD electrode. Recommendations for systematic S-ICD follow-up and troubleshooting are discussed.

Peer review status:ACCEPTED

27 Jan 2021Submitted to Journal of Cardiovascular Electrophysiology
01 Feb 2021Submission Checks Completed
01 Feb 2021Assigned to Editor
04 Feb 2021Reviewer(s) Assigned
14 Feb 2021Review(s) Completed, Editorial Evaluation Pending
15 Feb 2021Editorial Decision: Revise Minor
18 Feb 20211st Revision Received
22 Feb 2021Submission Checks Completed
22 Feb 2021Assigned to Editor
22 Feb 2021Reviewer(s) Assigned
23 Feb 2021Review(s) Completed, Editorial Evaluation Pending
01 Mar 2021Editorial Decision: Accept