Key result
Declining noninvasive electrogram amplitudes signal pacemaker lead insulation failure months before clinical manifestation.
Why the study?
Does routine measurement of noninvasive electrogram amplitude predict impending lead malfunction in patients with pacemaker leads?
Case Report (n=1)
Does routine measurement of noninvasive electrogram amplitude predict impending lead malfunction in patients with pacemaker leads?
Routine measurement of noninvasive electrogram amplitudes may serve as an early predictor of pacemaker lead insulation failure.
Answers are grounded in this paper and cite their sources.
May support early noninvasive detection of lead failure; hypothesis-generating case report requiring prospective validation before practice change.
Insulation failure of pacemaker leads may give rise to functional defects such as under- or oversensing, loss of capture or muscle stimulation. An increased incidence of such failures has been reported for the bipolar polyurethane-insulated Medtronic model 6972 pacing lead. It is therefore important to identify techniques that will detect such insulation defects early. A case report is presented in which diminishing electrogram amplitude at follow-up predicted lead failure several months before becoming clinically manifest. This finding suggests that routine measurement of such an electrogram may be a useful tool in predicting impending lead malfunction.
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BEEK et al. (1986) conducted a case report in Pacemaker lead insulation failure (n=1). Noninvasively measured electrogram amplitudes was evaluated on Prediction of impending lead malfunction. Gradual reduction in noninvasively measured electrogram amplitudes predicted pacemaker lead insulation failure several months before it became clinically manifest.
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