The efficacy of the LinoxSmart DX ICD lead from a single center experience.

PURPOSE: The Biotronik LinoxSmart DX implanted cardioverter defibrillator (ICD) lead is a novel VDD lead with the advantage of integrated atrial sensing dipole combined with a special augmentation and filtering mechanisms. We sought to determine the efficacy of the Biotronik LinoxSmart DX ICD lead. METHODS: Non-randomized consecutive patients implanted with Biotronik LinoxSmart DX lead at Sheba Medical Center were included in this study. Electrical parameters and arrhythmic events were recorded during follow up of one year. RESULTS: Seventy-three patients (69 males (94.5%), mean age 61 ± 12 years) were included. All patients were successfully implanted with a Biotronic VR-T DX device and LinoxSmart DX ICD lead (DX-17 in 37% and DX-15 in 63% patients). Mean P wave amplitude at time of implantation was 3.66 ± 2.9 mV and improved significantly throughout the follow-up (5.29 ± 4.39 mV, p = 0.009). Appropriate atrial sensing (defined as P wave amplitude of ≥0.8 mV) rate of 100% at implantation significantly decreased to 89% (p = 0.015) at 12 months. Three out of 67 (4.5%) patients without a known history of atrial fibrillation had documented new onset paroxysmal atrial fibrillation. Appropriate shocks occurred in 4 (5.5%) patients. One patient with atrial sensing less than 0.4 mV had inappropriate shock. CONCLUSIONS: Among patients implanted with the Biotronik LinoxSmart DX ICD lead in our single center, appropriate atrial sensing rate decreased over 12 months. Larger studies are needed to evaluate the reliability of long term appropriate atrial sensing.

Marcapasso cardíaco como alternativa ao cardiodesfibrilador implantável na prevenção secundária de morte súbita em casos selecionados / Cardiac pacemaker as an alternative to implantable cardioverter-defibrillator in secondary prevention of sudden death in selected cases

Relata-se o caso de uma paciente de 71 anos de idade, internada em decorrência de síndrome convulsiva de repetição. O monitoramento eletrocardiográfico contínuo permitiu documentar fibrilação ventricular com reversão espontânea, precedida por bradicardia sinusal grave e prolongamento acentuado do intervalo QT. Após investigação clínica detalhada, a paciente foi submetida a implante de marcapasso atrioventricular programadono modo AAI-DDD com 70 bpm. No seguimento de 30 meses, evoluiu sem sintomas cardiovasculares, comnormalização do intervalo QT e sem registros de taquicardia ventricular não sustentada. O marcapasso apresentou-se como alternativa bem-sucedida neste caso, evitando-se, assim, o implante de cardiodesfibrilador automático...

We present the case of a 71-year-old patient who was hospitalized for repetition convulsion syndrome.Continuous electrocardiographic monitoring enabled the documentation of ventricular fibrillation withspontaneous reversion, preceded by severe sinus bradycardia and marked prolongation of the QT interval. Afterdetailed clinical investigation, the patient was submitted to the implantation of atrioventricular pacemaker in theAAI-DDD 70 bpm mode. In the 30-month follow-up, the patient evolved without cardiovascular symptoms,normalization of the QT interval with no records of unsustained ventricular tachycardia. The pacemaker was asuccessful alternative in this case, avoiding the implantation of automatic defibrillator...