How to Detect and Manage Pacemaker/ICD Failure and Infections
Device therapy involving pacemakers for bradyarrhythmias and implantable cardioverter defibrillators (ICDs) for tachyarrhythmias has undergone a surprising evolution. System failure and infection, however, are still possible complications. In contrast to the relative frequency of lead failure, either as a result of implantation error or of deterioration of the lead materials, primary malfunction of the pulse generator is rare. The key to diagnosing device failure lies in meticulous assessment of the integrity of the leads and an understanding of the timing cycles of the specific device, which is facilitated by access to bidirectional telemetry. Infection is another complication of implanted devices; it is reported to occur in 0–19% of patients with pacemakers [1, 2] and in 2%–7% of patients with ICDs.
KeywordsInfective Endocarditis Implantable Cardioverter Defibrillator Lead Removal Lead Extraction Lead Failure
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