Abstract
Abrasion-induced insulation breach is a common failure mode of silicone-body, transvenous, implantable cardioverter defibrillator leads. It is caused either by external compression or internal motion of conducting cables. The present method of monitoring lead integrity measures low frequency conductor impedance. It cannot detect insulation failures until both the silicone lead body and inner fluoropolymer insulation have been breached completely, exposing conductors directly to blood or tissue. Thus the first clinical presentation may be either failure to deliver a life-saving shock or painful, inappropriate shocks in normal rhythm. We present a new method for identifying lead failure based on high frequency impedance measurements. This method was evaluated in 3D electromagnetic simulation and bench testing to identify insulation defects in the St. Jude Medical Riata® lead, which is prone to insulation breach.
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