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Implantable cardioverter-defibrillators (ICDs) are true lifesavers, but like all devices, their components potentially can malfunction. The natural life of a well-performing ICD lead, for instance, is about 10 years or so; however, several models of leads have higher rates of failure and a few have been subject to recall. Properly managing a patient with a failing lead or a recalled lead is a clinical challenge, due to a host of factors that must be balanced when determining the best interests of the patient.
Recently, electrophysiologist David B. DeLurgio, MD, of Emory University Crawford Long Hospital in Atlanta, had a difficult conversation with a patient in whom he had implanted an ICD in 2005. The ICD had been operating properly and twice had delivered appropriate shocks to...