Wiki ICD Lead Revision/Swap

leahlhaynie

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Hello!

I'm stuck on this report and could use some help, please.

Patient is a 54 year old male with a history of symptomatic sinus node dysfunction s/p permanent pacemaker in 2007 and ischemic cardiomyopathy s/p upgrade to ICD in 2009. His device was recently interrogated in office after he heard his device toning. Upon interrogation, intermittent non-physiologic oversensing on the RV P/S lead (original 5076 implanted in 2007), > 2000 short V-V intervals, and sudden drop in RV pacing impedance (with subsequent return to baseline) were noted. The findings were consistent with lead failure.

The chronic RV P/S lead (MDT 5076) was disconnected from the ICD generator. The P/S portion of the chronic RC ICD lead (MDT 6944) was uncapped and tested using the Medtronic PSA.

Seeing satisfactory measurements, the P/S portion of the ICD lead was connected to the existing ICD generator. The existing generator has an estimated battery longevity of several years, so it was decided to keep it in use at the time of revision. The previously disconnected pacing lead was capped.


DFT was done, so I plan on charging 93642. He didn't implant anything, nor was anything repositioned, unless a swap counts.

Thoughts?

Thank you!
Leah
 
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