Incidence and Management for Trouble-Shooting Associated with the Sprint-Fidelis ICD Lead

Abstract

Method: We investigated the outcomes of 136 patients with Sprint-Fidelis in 5 centers in Niigata Prefecture. Results Incidence: Lead troubles occurred in 9 patients (6.6%). The mean period before the trouble was 31 months (16–57 months). Implantation: Among these 9 patients, the lead was implanted using a cut-down technique in 4, an extra-thoracic approach in 4 and a subclavian approach in 1. Discovery: The lead troubles in 5 were discovered at regular clinics. The other 4 patients emergently visited because of the lead integrity alert (LIA) or inappropriate ICD discharges. In the 9 patients, the average sensing integrity counter was 338/day and mean F-F interval, of which was recognized as NST, was less than 200 ms. The LIA: The LIA had been programmed in 7, and 5 of the patients visited before inappropriate ICD discharges. However, the other 2 elderly patients couldn’t notice the alert sound. Extraction: Lead extraction was attempted in 6 and 5 leads were removable without any complications. Conclusions: The incidence of troubles with Sprint-Fidelis is high, and it occurs in the relatively late phase. The LIA is useful to detect the lead problems but its efficacy may be limited in elderly patients.