May 2019: It’s all in the trends!
Holly Daw - Chief Cardiac Physiologist
Barts Heart Centre, West Smithfield, London EC1A 7BE.
A 37-year-old male with a history of congenital heart disease (CHD), specifically repaired Tetralogy of Fallot and right sided aortic arch had a dual chamber ICD implanted for non-sustained VT with syncope. Since implant approximately a year device follow was largely unremarkable except for occasional non-sustained VT episodes that were self-terminating and caused no syncope or pre-syncope. The following trends were observed on remote monitoring routine follow-up.
Remote monitoring trends showing activity, heart rate and lead measurement trends over the last six months
What is the most likely cause for the lead trends observed?
□ Lead integrity issue
□ Header integrity issue
□ Surgical procedure
□ Medication change