Description of Event or Problem · 1
IT WAS REPORTED THAT THE SUBCUTANEOUS IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (S-ICD) DID NOT CONVERT THE ARRHYTHMIA DURING DEFIBRILLATION THRESHOLD (DFT) TESTING AT IMPLANT AND IMPEDANCE MEASUREMENTS WERE HIGH AROUND 180 OHMS. DURING THE PROCEDURE THE ELECTRODE WAS REPOSITIONED AND THE IMPEDANCE DECREASED TO 130 OHMS. HOWEVER, THE ARRHYTHMIA STILL WAS NOT CONVERTED WITH ANOTHER DFT TEST. ONE MONTH LATER THE PATIENT WAS BROUGHT BACK INTO THE OFFICE TO DISCUSS HAVING AN ADDITIONAL DFT TEST. TECHNICAL SERVICES (TS) WAS CONSULTED AGAIN AND DISCUSSED THE POSITION OF THE DEVICE AND ELECTRODE. IT WAS NOTED THAT IF DFT TESTING DID NOT CONVERT THE ARRHYTHMIA DURING THE NEXT DFT TEST, THE PHYSICIAN WOULD CONSIDER REVISING THE ELECTRODE. TS DISCUSSED THE OPTION OF REPOSITIONING THE S-ICD AT THE SAME TIME AS BASED UPON IMAGING, IT APPEARED TO BE IMPLANTED MID-LINE AND MAY HAVE BETTER CONVERSION IF POSITIONED SLIGHTLY MORE POSTERIOR. THE FIELD REPRESENTATIVE REACHED OUT THE CLINIC AND DETERMINED THE PATIENT HAS NOT YET UNDER GONE A SECOND DFT TEST AT THIS TIME DUE TO PERSONAL CHOICE. THE S-ICD AND ELECTRODE REMAIN IN SERVICE AND NO ADVERSE PATIENT EFFECTS WERE REPORTED.