|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 2004; 44:95-98, doi:10.1016/j.jacc.2004.03.051 © 2004 by the American College of Cardiology Foundation |
* University of Heidelberg/Cardiology, Heidelberg, Germany
Manuscript received November 10, 2003; revised manuscript received February 3, 2004, accepted March 16, 2004.
* Reprint requests and correspondence: Dr. Ruediger Becker, University of Heidelberg/Cardiology, Bergheimer Strasse 58, 69115 Heidelberg, Germany.
ruediger_becker{at}med.uni-heidelberg.de
OBJECTIVES: The purpose of this study was to analyze the utility of patient-alert features in implantable cardioverter defibrillators (ICDs).
BACKGROUND: Various alert features producing acoustic warning signals have been implemented in newer generation ICDs, but their role in early detection of system-related complications has not been systematically evaluated.
METHODS: In 240 patients implanted with Medtronic ICD devices, the following alert features were routinely activated: pacing lead impedance <200 or >2,000 
, high-voltage lead impedance <10 or >200 , low battery voltage (elective replacement indicator), long charge time (>18 s), >3 shocks delivered per episode, and all therapies in a zone delivered. Alert events occurring during follow-up were assessed in relation to actual findings (hospital charts, chest X-rays, ICD printouts including sensing/pacing/defibrillation threshold tests, episode data) to determine incidence, sensitivity, and specificity of the alert function.
RESULTS: During 12.2 ± 8.9 months, 24 alert events occurred in the 240 patients (pacing lead impedance, n = 4; high-voltage lead impedance, n = 7; low battery voltage, n = 1; >3 shocks, n = 6; all therapies, n = 6). A total of 22 serious complications (necessitating reprogramming or device/lead replacement) were observed, 14 of which were primarily identified through a patient alert (lead fracture, n = 11; connector defect, n = 1; T-wave oversensing, n = 1; battery depletion, n = 1). This reflects a sensitivity of 64% and a specificity of 96% of the alert function for serious complications. With 14 of 24 patient alerts being caused by serious complications, the positive predictive value reached 58%.
CONCLUSIONS: Patient-alert features are a useful additional tool facilitating early detection of serious ICD complications, but they do not substitute for regular ICD follow-up, because of their low sensitivity.
| ||||||||||||
This article has been cited by other articles:
|
|
 |
|
  L. van Erven and M. J Schalij Troubleshooting implantable cardioverter-defibrillator related problems Heart, May 1, 2008; 94(5): 649 - 660. [Full Text] [PDF]
|
|
|
|
 |
|
 D. Vollmann, L. Luthje, and M. Zabel Unusual cause for an increase of the sensing integrity counter in a patient with inappropriate implantable cardioverter-defibrillator therapy Europace, May 1, 2007; 9(5): 275 - 277. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Vollmann, A. Erdogan, E. Himmrich, J. Neuzner, D. Becker, C. Unterberg-Buchwald, J. Sperzel, and for the SAFE Study Investigators Patient AlertTM to detect ICD lead failure: efficacy, limitations, and implications for future algorithms. Europace, January 1, 2006; 8(5): 371 - 376. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Auer, R. Berent, and B. Eber Patient alert and cardiac defibrillators J. Am. Coll. Cardiol., March 15, 2005; 45(6): 966 - 966. [Full Text] [PDF]
|
|
|
|
|
|
R. Becker and W. Schoels Patient alert and cardiac defibrillators: Reply J. Am. Coll. Cardiol., March 15, 2005; 45(6): 966 - 966. [Full Text] [PDF]
|
|
|
|
|
|
J. C. Senges-Becker, M. Klostermann, R. Becker, A. Bauer, K. E. Siegler, H. A. Katus, and W. Schoels What is the "Optimal" follow-up schedule for ICD patients? Europace, January 1, 2005; 7(4): 319 - 326. [Abstract] [Full Text] [PDF]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
