Analysis of arrhythmic events is useful to detect lead failure earlier in patients followed by remote monitoring

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Cardiovascular implantable electronic devices (CIEDs) have expanded in number and complexity.1 Standard ambulatory follow‐up is time consuming, and it is difficult to detect asymptomatic CIED malfunction in the early stage. Remote monitoring (RM) of CIEDs has been advocated as the new standard of care for patients with CIEDs. Several large prospective randomized trials have demonstrated the safety, feasibility, efficacy, and improved survival of RM. Furthermore, RM has allowed the early detection of adverse clinical events, such as arrhythmia, lead failure, and battery depletion.2
In some cases, lead failure has resulted in life‐threatening events, especially in patients with cardiac pacing dependence, clinical lethal arrhythmia, and high‐voltage implantable cardioverter defibrillator (ICD) leads.6 RM could detect lead failure earlier,11 which may have resulted in the reduction of inappropriate ICD shocks.14 However, lead failure was often noted only by arrhythmic events, not by impedance abnormalities.14 In such cases, human analysis of intracardiac electrograms of arrhythmic events is needed to identify lead failure.
The aim of this study was to compare the usefulness of arrhythmic events with conventional impedance abnormalities for identifying lead failure in CIED patients followed by RM.
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