Lead Integrity Alert Is Useful for Assessment of Performance of Biotronik Linox Leads

Steinberg, Christian; Padfield, Gareth J.; Hahn, E.; Flavelle, S.; McIlroy, Cheryl; Bremen, Otto Van; Yeung‐Lai‐Wah, John A.; Kerr, Charles R.; Deyell, Marc W.; Tung, Stanley; Andrade, Jason G.; Bennett, Matthew T.; Bashir, Jamil; Krahn, Andrew D.; Chakrabarti, Santabhanu

doi:10.1111/jce.12832

Cited by 9 publications

(1 citation statement)

References 24 publications

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“…This is important because each manufacturer has its own proprietary sensing filters and algorithms. Medtronic devices have a proprietary Lead Integrity Alert (LIA TM ) which is sensitive to nonphysiological short V-V sensing intervals: this algorithm can be useful to assess lead performance, including Linox[ 14 ], but when used with non-Medtronic leads it can potentially overestimate the incidence of failure.…”

Section: Discussionmentioning

confidence: 99%

Externalized conductors and insulation failure in Biotronik defibrillator leads: History repeating or a false alarm?

Maria¹,

Borghi²,

Bonetti³

et al. 2017

WJCC

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Conductor externalization and insulation failure are frequent complications with the recalled St. Jude Medical Riata implantable cardioverter-defibrillator (ICD) leads. Conductor externalization is a “unique” failure mechanism: Cables externalize through the insulation (“inside-out” abrasion) and appear outside the lead body. Recently, single reports described a similar failure also for Biotronik leads. Moreover, some studies reported a high rate of electrical dysfunction (not only insulation failure) with Biotronik Linox leads and a reduced survival rate in comparison with the competitors. In this paper we describe the case of a patient with a Biotronik Kentrox ICD lead presenting with signs of insulation failure and conductor externalization at fluoroscopy. Due to the high risk of extraction we decided to implant a new lead, abandoning the damaged one; lead reimplant was uneventful. Subsequently, we review currently available literature about Biotronik Kentrox and Linox ICD lead failure and in particular externalized conductors. Some single-center studies and a non-prospective registry reported a survival rate between 88% and 91% at 5 years for Linox leads, significantly worse than that of other manufacturers. However, the preliminary results of two ongoing multicenter, prospective registries (GALAXY and CELESTIAL) showed 96% survival rate at 5 years after implant, well within industry standards. Ongoing data collection is needed to confirm longer-term performance of this family of ICD leads.

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Section: Discussionmentioning

confidence: 99%

Externalized conductors and insulation failure in Biotronik defibrillator leads: History repeating or a false alarm?

Maria¹,

Borghi²,

Bonetti³

et al. 2017

WJCC

View full text Add to dashboard Cite

show abstract

Troubleshooting

Swerdlow

Friedman

Asirvatham

et al. 2021

Cardiac Pacing, Defibrillation and Resynchronization

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Sensing and detection in Medtronic implantable cardioverter defibrillators

Brown

Swerdlow²

2016

Herzschr Elektrophys

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Ensuring sensing and detection of ventricular tachycardia (VT) and ventricular fibrillation (VF) was a prerequisite for the clinical trials that established the survival benefit of implantable cardioverter defibrillators (ICDs). However, for decades, a high incidence of unnecessary shocks limited patients' and physicians' acceptance of ICD therapy. Oversensing, misclassification of supraventricular tachycardia (SVT) as VT, and self-terminating VT accounted for the vast majority of unnecessary shocks. Medtronic ICDs utilize sensitive baseline settings with minimal blanking periods to ensure accurate sensing of VF, VT, and SVT electrograms. Programmable algorithms reject oversensing caused by far-field R waves, T waves, and non-physiologic signals caused by lead failure. A robust hierarchy of SVT-VT discriminators minimize misclassification of SVT as VT. These features, combined with evidence-based programming, have reduced the 1‑year inappropriate shock rate to 1.5 % for dual-/triple-chamber ICDs and to 2.5 % for single-chamber ICDs.

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Lead Integrity Alert Is Useful for Assessment of Performance of Biotronik Linox Leads

Abstract: A positive LIA trigger in Biotronik Linox ICD-leads is highly predictive of lead failure. LIA is useful in ongoing surveillance of lead performance.

Cited by 9 publications

References 24 publications

Externalized conductors and insulation failure in Biotronik defibrillator leads: History repeating or a false alarm?

Externalized conductors and insulation failure in Biotronik defibrillator leads: History repeating or a false alarm?

Troubleshooting

Sensing and detection in Medtronic implantable cardioverter defibrillators

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