Towards eradication of inappropriate therapies for ICD lead failure by combining comprehensive remote monitoring and lead noise alerts

Sylvain Ploux*, Charles D. Swerdlow, Marc Strik, Nicolas Welte, Nicolas Klotz, Philippe Ritter, Michel Haissaguerre, Pierre Bordachar

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


IntroductionRecognition of implantable cardioverter defibrillator (ICD) lead malfunction before occurrence of life threatening complications is crucial. We aimed to assess the effectiveness of remote monitoring associated or not with a lead noise alert for early detection of ICD lead failure. MethodsFrom October 2013 to April 2017, a median of 1,224 (578-1,958) ICD patients were remotely monitored with comprehensive analysis of all transmitted materials. ICD lead failure and subsequent device interventions were prospectively collected in patients with (RMLN) and without (RM) a lead noise alert (Abbott Secure Sense or Medtronic Lead Integrity Alert) in their remote monitoring system. ResultsDuring a follow-up of 4,457 patient years, 64 lead failures were diagnosed. Sixty-one (95%) of the diagnoses were made before any clinical complication occurred. Inappropriate shocks were delivered in only one patient of each group (3%), with an annual rate of 0.04%. All high voltage conductor failures were identified remotely by a dedicated impedance alert in 10 patients. Pace-sense component failures were correctly identified by a dedicated alert in 77% (17 of 22) of the RMLN group versus 25% (8 of 32) of the RM group (P=0.002). The absence of a lead noise alert was associated with a 16-fold increase in the likelihood of initiating either a shock or ATP (OR: 16.0, 95% CI 1.8-143.3; P=0.01). ConclusionICD remote monitoring with systematic review of all transmitted data is associated with a very low rate of inappropriate shocks related to lead failure. Dedicated noise alerts further reduce inappropriate detection of ventricular arrhythmias.
Original languageEnglish
Pages (from-to)1125-1134
Number of pages10
JournalJournal of Cardiovascular Electrophysiology
Issue number8
Publication statusPublished - 1 Aug 2018


  • implantable cardioverter defibrillator
  • inappropriate shock
  • inappropriate therapy
  • lead failure
  • lead noise algorithm
  • remote monitoring
  • telemedicine


Dive into the research topics of 'Towards eradication of inappropriate therapies for ICD lead failure by combining comprehensive remote monitoring and lead noise alerts'. Together they form a unique fingerprint.

Cite this