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PubMed · 7521047

A report using a hybrid ICD system: the need for compatibility among implanted defibrillator components.

D Newman·P Dorian·J Yao·J Hart·J Hardy
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Abstract

The successful implantation of an ICD system with hardware from three different manufacturers is described. This case exemplifies the need for compatibility of components among different manufacturers. This is most relevant at a time when rapidly changing technology and hardware availability may require a mixing, by informed practitioners, of ICD system components. The parallel to the development of the uniform IS-1 standard for bradycardia devices is made.

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Defibrillators, ImplantableHumansMiddle AgedCase ReportsJournal Article

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BibTeXRIS

D Newman, P Dorian, J Yao, J Hart, J Hardy. 1994. A report using a hybrid ICD system: the need for compatibility among implanted defibrillator components.. https://doi.org/10.1111/j.1540-8159.1994.tb01480.x

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Does the rate of inappropriate therapy differ in implantable cardioverter-defibrillators from different manufacturers?

OBJECTIVE: We conducted this study to compare the rate of >/=1 inappropriate therapy between ICDs from two manufacturers which use different discriminatory protocols. METHOD: One hundred sixty two patients (mean age 58 +/- 13 years, 126 male) who received ICDs between January 2001 and 2005 were included in the study. Clinical, electrocardiographic, and ICD stored data and electrograms were collected and analyzed. Immediately after implantation all the detection and discrimination criteria were activated with the nominal values in order to compare the two discriminatory protocols under the default manufacturer's settings. RESULTS: During the follow up period of 14.3 +/- 10 months, 49 (30%) patients received >/=1 inappropriate ICD therapy. The rate of >/=1 inappropriate ICD therapy in manufacturer A and B ICDs was 26% (n = 29) and 41% (n = 20), respectively. Comparing the rate of >/=1 inappropriate ICD therapy between the two groups by Kaplan-Meier analysis and the log rank test resulted in P = 0.04. CONCLUSION: Having all discriminatory variables activated with the nominal values, discriminatory performance differs between the two manufacturers. Further larger-scale studies are warranted to prospectively compare the performance of various available ICDs' discriminatory protocols, and define the optimum combination of discriminators in each ICD to decrease the rate of inappropriate therapy.

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PubMed2007

Cardiac pacemakers and implantable cardioverter defibrillators: in vitro magnetic resonance imaging evaluation at 1.5-tesla.

RATIONALE AND OBJECTIVES: To evaluate the effect of Magnetic Resonance Imaging (MRI) performed at 1.5-Tesla on current generation pacemakers and ICDs to identify safe parameters for MRI examinations. METHODS: Pacemakers (Identity ADx XL DR+ 5386 and Identity ADx DR + 5380 generators; 1688T/52-cm atrial and ventricular leads) and ICDs (Atlas + V-243, Epic + V-236, and Epic + HF V-350 generators; Riata 1581/65-cm and QuickSite 1056K/75-cm leads; St. Jude Medical, Sylmar, California, USA) were evaluated for magnetic field interactions. MRI-related heating was assessed using various levels of RF power (SARs) and conditions that included scans on different body regions. Functional aspects of the devices were evaluated immediately before and after MRI procedures utilizing nine different pulse sequences. Induced currents were measured using a custom built system. RESULTS: Magnetic field interactions will not create a hazard for these pacemakers and ICDs. All scans of the "head" and "lumbar" regions resulted in temperature changes < or =0.5 degrees C at SARs ranging from 2.0 to 3.0-W/kg. For the "chest" area, temperature increases ranged from 0.4 degrees C to 3.6 degrees C at an SAR of 2.0-W/kg. No memory corruption, hardware changes, or changes in device parameters were seen. Magnetic field gradients have a low likelihood of inducing currents that would stimulate the heart. CONCLUSIONS: No hazardous magnetic field interactions or physiologically significant heating occurred for certain conditions. There was no permanent effect on device function. By following specific conditions, these pacemakers and ICDs may be safe for patients scanned at 1.5-Tesla.

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