Key result
24-hour Holter event marker recording detects rate sensing lead failure missed during brief laboratory monitoring.
Why the study?
Differentiation of certain types of sensing abnormalities in third-generation ICDs may be difficult prior to surgical exploration due to limitations in electrogram recordings.
Does 24-hour continuous Holter monitor recording of the event marker improve the diagnosis of ICD lead failure compared to brief laboratory recording in patients with suspected sensing abnormalities?
Case Report (n=1)
Does 24-hour continuous Holter monitor recording of the event marker improve the diagnosis of ICD lead failure compared to brief laboratory recording in patients with suspected sensing abnormalities?
Continuous 24-hour Holter monitoring of ICD event markers can diagnose intermittent lead failure that may be missed during brief in-clinic evaluations.
Alerts clinicians to diagnostic ambiguity in ICD lead failures; leaves open whether dual-lead electrograms would aid differentiation.
Stored electrograms enhance the ability to evaluate therapy episodes in the third-generation implantable cardioverter defibrillator. These electrograms are recorded from either the shocking or rate sensing leads, but not both. As a result, differentiation of certain types of sensing abnormalities may be difficult prior to surgical exploration. We present a case of rate sensing lead failure due to an insulation break. Several minutes of recording of the event marker in the laboratory failed to document any abnormal sensing; the diagnosis was made by recording the event marker on a 24-hour continuous (Holter) monitor. The Holter monitor/event marker combination was of substantial diagnostic value and allowed for a more focused surgical evaluation and treatment.
No takes yet. Share an insight, caveat, or question.
Horton et al. (1995) conducted a case report in ICD rate sensing lead failure (n=1). 24-hour continuous (Holter) monitor with event marker recording was evaluated on Diagnosis of abnormal sensing. Recording the event marker on a 24-hour continuous Holter monitor successfully diagnosed rate sensing lead failure that was missed during brief laboratory recording.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: