Inappropriate Shocks in Patients With Fidelis® Lead Fractures: Impact of Remote Monitoring and the Lead Integrity Algorithm.
Prevention of Shocks With Fidelis Lead Fractures. Introduction: The role of remote monitoring combined with lead integrity algorithm (LIA) in patients with Fidelis (Medtronic Inc., Minneapolis, MN, USA) lead fractures is not well defined. Methods: We retrospectively identified patients with Fideli...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 22; no. 10; pp. 1107 - 1115 |
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| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts tracings Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=66394206&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 66394206 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Oct2011 vid: 22 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 66394206 104698964 104698964 10.1111/j.1540-8167.2011.02077.x 66394206 ppf: 1107 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Inappropriate Shocks in Patients With Fidelis® Lead Fractures: Impact of Remote Monitoring and the Lead Integrity Algorithm. aug: au: BLANCK, ZALMEN AXTELL, KATHI BRODHAGEN, KATHY O'HEARN, LAURA ALBELO, TAMMY CERETTO, CHERYL DHALA, ANWER SRA, JASBIR AKHTAR, MASOOD affil: Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, University of Wisconsin School of Medicine and Public Health, Milwaukee, Wisconsin, USA sug: subj: Algorithms Electrodes, Implanted Adverse Effects Equipment Failure Adverse Effects Defibrillators, Implantable Adverse Effects Remote Access to Information Wireless Communications Telemetry Methods Human Male Female Aged Middle Age Descriptive Statistics Databases Software Wilcoxon Rank Sum Test Fisher's Exact Test Kruskal-Wallis Test Treatment Outcomes Retrospective Design Aged: 65+ years Middle Aged: 45-64 years Male Female ab: Prevention of Shocks With Fidelis Lead Fractures. Introduction: The role of remote monitoring combined with lead integrity algorithm (LIA) in patients with Fidelis (Medtronic Inc., Minneapolis, MN, USA) lead fractures is not well defined. Methods: We retrospectively identified patients with Fidelis lead fractures at our institution, documenting all pertinent data (remote monitoring use, clinical presentation, lead fracture diagnosis criteria). Patients were classified into subgroups based on the type of home monitoring and whether LIA was uploaded before lead fracture. Subgroups were compared based on delivery of inappropriate shocks (IS). Results: A total of 131 patients (mean age 62 ± 16 years, 70% male, 69% primary prevention implants) were followed until lead fracture (average 32 ± 12 months). IS were delivered in 21% of patients (n = 11/52) with LIA versus 52% (n = 41/79) without LIA, P < 0.001. LIA significantly decreased the number of IS (2.1 ± 1.0 IS vs 7.9 ± 12 IS, P < 0.001) and significantly increased the number of patients diagnosed through audible alert (P < 0.001). Wireless monitoring significantly decreased the time interval to reprogram defibrillators OFF (mean 1.5 ± 1 days vs 15.6 ± 18 days with nonwireless CareLink [Medtronic Inc.] and 12.4 ± 20 days without CareLink, P < 0.001); 14% of patients with LIA and wireless monitoring combined received IS. Without LIA, 63% of patients with wireless monitoring received IS. Conclusion: This study confirms that LIA significantly decreases IS therapy in patients with Fidelis lead fractures. Wireless technology enhances LIA benefits by significantly shortening time to reprogram defibrillators. However, despite the 'best scenario' of combining LIA and wireless monitoring, 14% of patients with lead fractures still get IS. Further refinements of detection algorithms are required to eliminate this significant clinical problem. (J Cardiovasc Electrophysiol, Vol. 22, pp. 1107-1114, October 2011) pubtype: Academic Journal doctype: research tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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