Diagnosis of high-voltage conductor fractures in Sprint Fidelis leads.

Background: Fractures of pace/sense conductors in implantable cardioverter-defibrillator (ICD) leads have been studied extensively, but little is known about fractures of high-voltage (HV) conductors.

Objective: To characterize the presentation of isolated HV conductor fractures, define the optimal impedance threshold for identifying them, and compare it to the existing nominal impedance threshold (200 Ω) for patient and remote-monitoring alerts.

Methods: This retrospective study analyzed HV fractures in explanted, dual-coil, model 6949 Sprint Fidelis leads (Medtronic, Minneapolis, MN).