Nonphysiologic noise early after defibrillator implantation in Canada: Incidence and implications Academic Article uri icon

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abstract

  • BACKGROUND: Following recent cases of nonphysiologic noise noted early after defibrillator implantation, the Canadian Heart Rhythm Society Device Committee decided to evaluate the implications of this problem. OBJECTIVE: To determine the incidence and consequences of nonphysiologic noise early after defibrillator implantation. METHODS: The Canadian Heart Rhythm Society Device Committee surveyed all Canadian defibrillator implanting centers regarding their implant volumes and number of cases where nonphysiologic noise had been noted early (< 24 hours) after implant over the preceding 2 years. For such cases, information regarding the manufacturer and occurrence of inappropriate shock or inhibition of pacing was reported. RESULTS: Responses were obtained from 20 of 23 surveyed implanting centers, with a total implant volume of 4960 defibrillators per year. The occurrence of nonphysiologic noise early after implantation was noted in 25 cases over the preceding 2 years (0.25%). Noise was detected in devices of all 3 of the leading volume device manufacturers. There were 2 cases of inappropriate shocks and 2 cases of symptomatic pacing inhibition. In 4 cases, removal of the lead from the header and retesting with the analyzer confirmed normal lead function. In all cases, the noise resolved within 24 hours. CONCLUSION: Nonphysiologic noise early after defibrillator implantation was noted in 0.25% of procedures and was not limited to one specific manufacturer. This noise may result in an inappropriate shock or inhibition of pacing in a pacemaker-dependent patient. This transient phenomenon, possibly related to fluid and/or air in the header, appears to always resolve without surgical intervention.

authors

  • Essebag, Vidal
  • Champagne, Jean
  • Birnie, David H
  • Verma, Atul
  • Healey, Jeffrey Sean
  • Simpson, Christopher S
  • Kus, Teresa
  • Thibault, Bernard
  • Mangat, Iqwal
  • Tung, Stanley
  • Sterns, Laurence
  • Exner, Derek V
  • Davies, Ted
  • Coutu, Benoit
  • Crystal, Eugene
  • Stephenson, Elizabeth A
  • Connors, Sean
  • Paredes, Felix Ayala
  • Parkash, Ratika
  • Krahn, Andrew D

publication date

  • March 2012