DF-1 and DF-4 defibrillator leads
The industry standards IS-1 and DF-1 enable interchangeability of
generators and leads from different manufacturers since the late 1980s.
Corresponding defibrillator leads feature two (single-coil lead; one
IS-1, one DF-1) or three (dual coil lead; one IS-1 and two DF-1)
connectors. The DF-4 standard was introduced in 2010 as a simpler
solution with only one connection between lead and device, aiming to
reduce material in the pocket, facilitate the implantation procedure,
and lowering the risk of lead-to-port mismatch.
Our case demonstrates an important clinical advantage of the older
DF1/IS1 standard [7], namely the possibility to simply add a
pace/sense lead to overcome the problem of chattering.
[1] Moisés Rodríguez-Mañero, MD*; Carlo de Asmundis, MD, PhD*;
T-Wave Oversensing in Patients With Brugada Syndrome: True Bipolar
Versus Integrated Bipolar Implantable Cardioverter Defibrillator Leads;
Circulation: Arrhythmia and Electrophysiology. 2015;8:792–798
[2] Gunderson BD, Swerdlow CD, Wilcox JM, Hayman JE, Ousdigian KT,
Ellenbogen KA. Causes of ventricular oversensing in implantable
cardioverter-defibrillators: implications for diagnosis of lead
fracture. Heart Rhythm. 2010;7(5):626–633.2
[3] Ng J, Chopra N, Barbhaiya C, Reichlin T, Nof E, Nagashima K,
Tadros T, Koplan B. Incidence of nonphysiologic short VV intervals
detected by the sensing integrity counter with integrated bipolar
compared with true bipolar leads: clinically inconsequential or cause
for concern? J Interv Card Electrophysiol. 2014;39(3):281–285.
[4] Weretka S, Michaelsen J, Becker R, Karle CA, Voss F, Hilbel T,
Osswald BR, Bahner ML, Senges JC, Kuebler W, Schoels W. Ventricular
oversensing: a study of 101 patients implanted with dual chamber
defibrillators and two different lead systems. Pacing Clin
Electrophysiol. 2003;26(1 Pt 1):65–70.
[5] Sticherling C, Klingenheben T, Hohnloser SH. An Unusual Cause of
ICD Shock. PACE 20:2265-2267, 1997
[6] Pfitzner P, Trappe HJ. Oversensing in a cardioverter
defibrillator system caused by interaction between two endocardial
defibrillation leads in the right ventricle. Pacing Clin Electrophysiol.
1998;21(4 Pt 1):764–768.
[7] Sticherling C, Burri H. Introduction of new industry standards
for cardiac implantable electronic devices: balancing benefits and
unexpected risks; Europace (2012) 14, 1081–1086