Unique Features

Implantable Cardiac Devices

Lead Integrity Alert

Medtronic Lead Integrity Alert™ (LIA) significantly improves early identification of potential implantable cardioverter-defibrillator (ICD) lead fractures.1

Clinical Need

"Cumulative lead malfunction incidence is 4.6% at 10 years across manufacturers. Lead malfunction resulted in inappropriate shocks in 76% of the cases."2

Only Medtronic Lead Integrity Alert automatically offers Proactive Protection:  Less shocks. Improved monitoring. Advanced warning.1,3-5

Lia Operation

Important Safety Information

Once audible alert is triggered, patient should seek immediate medical attention to prevent delivery of an inappropriate shock. Lead Integrity Alert does not withhold therapy.

LIA offers added protection for ICD patients through more frequent audible alarms and is the first continuous ICD monitoring technology that triggers real-time device changes to reduce unnecessary shocks that could result from potential lead fractures.

References

  1. Swerdlow CD, Gunderson BD, Ousdigian KT. Downloadable Algorithm to Reduce Inappropriate Shocks Caused by Fractures of Implantable Cardioverter-Defibrillator Leads. Circulation. 2008;118:2122-2129.
  2. Eckstein J, et al. Necessity for Surgical Revision of Defibrillator Leads Implanted Long-Term Causes and Management. Circulation. 2008;117:2727-2733.
  3. Wilkoff BL. Aggressively programmed implantable defibrillator detection and therapy reduces shocks compared to physician-tailored programming in primary prevention patients: results from the PREPARE trial. Presented at: Annual Meeting of the Heart Rhythm Society. May 10, 2007; Denver, CO.
  4. Swerdlow CD, Gunderson BD, Stadler RW, et al. Inappropriate shocks due to Sprint Fidelis® ICD lead fracture may be reduced by programming more intervals for detection of ventricular fibrillation. Heart Rhythm. 2008;5 (Suppl 5S):S33. (Presented Abstract AB16-5).
  5. Patel AS, et al. LIA for Vision 3D™ devices. Abstract: Modification to LIA Improves Performance – HRS Conference 2009.

How It Works

Only Medtronic Lead Integrity Alert Automatically Offers Proactive Protection1-4

According to published studies, Medtronic’s Lead Integrity Alert™ (LIA) significantly improves early identification of potential implantable cardioverter-defibrillator (ICD) lead fractures.1-4

Important Safety Information

Once audible alert is triggered, patient should seek immediate medical attention to prevent delivery of an inappropriate shock. Lead Integrity Alert does not withhold therapy.

LIA offers added protection for ICD patients through more frequent audible alarms and is the first continuous ICD monitoring technology that triggers real-time device changes to reduce unnecessary shocks that could result from potential lead fractures.*

View how LIA works (0:43, 2.2 MB)

LIA Operation

Enhanced LIA Operation in Vision 3D Devices

Technical differences of Lead Integrity Alert for legacy devices compared to newer devices are available in the downloadable material below.

LIA Technical Comparison sheet (PDF, 99 KB)

LIA Follow-up for Clinicians (PDF, 1.3 MB) downloadable tip card
One-page tip card with LIA follow-up considerations

LIA Automated Proactive Protection provides:

Less Shocks1-4

  • Increases sensitivity of detecting lead fractures compared with fixed impedance3,4
  • Safely automatically extends the VF detection NID to 30/40 when the alert is triggered1-4
  • Reduces the chance of inappropriate shocks1-4

Improved Monitoring2-4

  • Monitors lead integrity continuously – 24/7
  • Improved diagnostics triggered by oversensing
  • CareAlert® notification sent to clinic for wireless devices

Advanced Warning*

  • 75% of patients will receive a minimum of three days’ notice to seek medical attention2-4
  • Audible alert sounds immediately, every four hours, and at the programmed time

Important Safety Information

Once  audible alert is triggered, patient should seek immediate medical attention to prevent delivery of an inappropriate shock. Lead Integrity Alert does not withhold therapy.

LIA Operation 

Detail - Patient audio alert tip card

Request for Information Form to order Patient Audio Alert Tip Cards

Listen to LIA Audio Alerts

 

LIA Patient Case Study (PDF, 193 KB)

* Patient should seek immediate medical attention. See manual for further information.

References

  1. Wilkoff BL. Aggressively programmed implantable defibrillator detection and therapy reduces shocks compared to physician-tailored programming in primary prevention patients: results from the PREPARE trial. Presented at: Annual Meeting of the Heart Rhythm Society. May 10, 2007; Denver, CO.
  2. Swerdlow CD, Gunderson BD, Stadler RW, et al. Inappropriate shocks due to Sprint Fidelis® ICD lead fracture may be reduced by programming more intervals for detection of ventricular fibrillation. Heart Rhythm. 2008;5 (Suppl 5S):S33. (Presented Abstract AB16-5).
  3. Swerdlow CD, Gunderson BD, Ousdigian KT. Downloadable Algorithm to Reduce Inappropriate Shocks Caused by Fractures of Implantable Cardioverter-Defibrillator Leads. Circulation. 2008;118:2122-2129.
  4. Patel AS, et al. LIA for Vision 3D™ devices. Abstract:Modification to LIA Improves Performance – HRS Conference 2009.

Proven Performance

Only LIA Automatically Offers Proactive Protection1-4

  • LIA performance was retrospectively estimated using data from 15,970 patients with Sprint Fidelis® leads on Medtronic CareLink® Network.2
  • LIA accurately and automatically provides at least 3 days advanced warning in 3 out of 4 patients with lead fracture.2-4
  • The Enhanced LIA rate of False Positives is very low – 1 in 1,285 patient-years.4

Important Safety Information

Once audible alert is triggered, patient should seek immediate medical attention to prevent delivery of an inappropriate shock. Lead Integrity Alert does not withhold therapy.

References

  1. Wilkoff BL. Aggressively programmed implantable defibrillator detection and therapy reduces shocks compared to physician-tailored programming in primary prevention patients: results from the PREPARE trial. Presented at: Annual Meeting of the Heart Rhythm Society. May 10, 2007; Denver, CO.
  2. Swerdlow CD, Gunderson BD, Stadler RW, et al. Inappropriate shocks due to Sprint Fidelis® ICD lead fracture may be reduced by programming more intervals for detection of ventricular fibrillation. Heart Rhythm. 2008;5 (Suppl 5S):S33. (Presented Abstract AB16-5).
  3. Swerdlow CD, Gunderson BD, Ousdigian KT. Downloadable Algorithm to Reduce Inappropriate Shocks Caused by Fractures of Implantable Cardioverter-Defibrillator Leads Circulation. 2008;118:2122-2129.
  4. Patel AS, et al. LIA  for Vision 3D™ devices. Abstract:Modification to LIA Improves Performance – HRS Conference 2009.

Lead Integrity Alert Patient Case

  • Patient heard alert and presented to the clinic. Impedance Trend showed crossing > 1,000 ohms.
  • Lead Integrity Alert (LIA) was triggered.
  • Stored EGM was assessed by clinician to determine the cause of the alert.
  • The EGM confirmed noise detected on the tip-to-ring portion – lead fracture is suspected. Physician intervenes to prevent patient from receiving inappropriate shock.

LIA Patient case study details (PDF, 193 KB)

Lead Integrity Alert Follow-Up Considerations – Medtronic CareLink® Network

  1. Once Audible Alert is triggered, patient should seek immediate medical attention to prevent delivery of an inappropriate shock. Therapy is not turned off by the device.
  2. Once the patient is in office, place heart monitor on patient and suspend VT/VF detection until a definitive treatment plan has been formalized.
  3. Perform follow-up testing that is standard for your practice to assess a suspect lead. Additionally, the diagnostics described on this downloadable tip card may provide insightful information.

LIA Follow-up for Clinicians (PDF, 1.3 MB)
One-page tip card with LIA follow-up considerations for clinicians
 

Last updated: 30 Mar 2011

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