Unwinding Life In The Heart; A Case of Internal Cardioverter-Defibrillator Lead Malfunction

摘要

BACKGROUND: Internal cardioverter-defibrillator (ICD) lead malfunctions such as disintegration and externalization are rare but serious complications noted, and are of growing concern.CASE REPORT: A 63-year-old woman presented with complaint of hearing "beeping sounds" from her ICD. Interrogation of her defibrillator revealed a gradual increase in the lead impedance. ICD lead fluoroscopy showed externalized ICD lead components, a rare finding that has been recently reported in the literature with St. Jude Medical Riata ICD leads. She subsequently developed asystole and intermittent ventricular failure to capture, requiring an urgent temporary transvenous pacemaker before ICD lead replacement. CONCLUSION: Exteriorization of the ICD lead is rare, but is a potentially serious complication of the newer ICD systems resulting in a series of advisories and manufacturers' recall. There is no consensus if patients who already have these leads implanted, should have them replaced.