Mirror, Mirror in the leads, is there insulation breach?
Pacemaker lead failure is most commonly due to insulation defects with a 4-year incidence of 4-13%, and increases over time.1-3 The most frequent cause is subclavian crush syndrome (SCS) whereby mechanical friction at the first-rib-clavicular junction causes erosion of exposed leads, often due to medial venous access.2,4 However, insulation breaches can occur anywhere along the lead caused by friction between leads, or lead and device.5 Other contributing factors for insulation abrasions include lead anatomy, age, excessive intracardiac length and patient factors.
Authors
- Gareth Wynn (ORCID: https://orcid.org/0000-0002-1935-8155)
- D. Liang (ORCID: https://orcid.org/0009-0005-5354-1673)
- Janet X C Chen
- Gregory King (ORCID: https://orcid.org/0000-0001-6288-1702)
- G. Wong (ORCID: https://orcid.org/0000-0002-9733-7712)
- Han S Lim (ORCID: https://orcid.org/0000-0002-8532-7891)
Institutions
- The Royal Melbourne Hospital (AU)
- The University of Melbourne (AU)
- Austin Health (AU)
Publication Details
- Journal
- HeartRhythm Case Reports
- Published
- 2025-06-16
- DOI
- https://doi.org/10.1016/j.hrcr.2025.06.013
- Primary Topic
- Cardiac pacing and defibrillation studies
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Boston Scientific Corporation
- Cook Medical
- Cardiac Society of Australia and New Zealand
- Royal Australasian College of Physicians
- Vincent Fairfax Family Foundation
- MicroPort