We report on a patient with a single-chamber implantable cardioverter defibrillator admitted with an increase in high-voltage lead impedance, detected with home-monitoring, and inappropriate shocks due to noise on the electrogram. Chest x-ray revealed no abnormalities. Fluoroscopy before the revision procedure showed insulation failure with migration of the shock wire in the heart. The lead was removed and replaced with a new shock lead. This is, as far as we know, the first report on such a particular insulation failure, detected with home-monitoring and inappropriate shocks. (PACE 2010; 33:770-772).

Defibrillation, Internal cardioverter defibrillator, Ventricular tachycardia
dx.doi.org/10.1111/j.1540-8159.2009.02664.x, hdl.handle.net/1765/27747
Pacing and Clinical Electrophysiology
Erasmus MC: University Medical Center Rotterdam

Valk, S.D.A, Luijten, R, & Jordaens, L.J.L.M. (2010). Insulation damage in a shock wire: An unexpected fluoroscopic image. Pacing and Clinical Electrophysiology, 33(6), 770–772. doi:10.1111/j.1540-8159.2009.02664.x