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Early detection of high voltage lead failure with an unusual and unexpected device alert
  1. Giovanni B Forleo,
  2. Germana Panattoni,
  3. Valentina Schirripa,
  4. Domenico G Della Rocca,
  5. Domenico Sergi,
  6. Luca Santini,
  7. Manfredi Tesauro,
  8. Francesco Romeo
  1. Department of Internal Medicine, Division of Cardiology, University of Rome ‘Tor Vergata’, Rome, Italy
  1. Correspondence to Dr Giovanni B Forleo, Division of Cardiology, University Hospital of Tor Vergata, Viale Oxford, 81, Roma 00133, Italy; forleo{at}

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To the Editor Despite the positive effect on prevention of sudden cardiac death, implantable cardioverter defibrillator (ICD) therapy is associated with potential malfunctions of the implanted system. Although detected by electrical parameters during routine ICD controls, lead defects are recognised after the occurrence of inappropriate shocks in a significant proportion of patients.

Various alert features have been implemented in newer generation ICDs in order to improve the management of device-implanted patients and provide early warnings of lead dysfunction. Recently, ICDs with the ability of continuous ST-segment monitoring through the ventricular lead have been developed. These devices continuously …

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