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Introduction of new industry standards for cardiac implantable electronic devices: balancing benefits and unexpected risks

Authors: Sticherling, Christian; Burri, Haran Kumar;

Introduction of new industry standards for cardiac implantable electronic devices: balancing benefits and unexpected risks

Abstract

The DF-4 connector is a novel industry standard for the connection of a defibrillator lead to the generator. It aims at reducing the bulk created by two or three pins at the proximal end of the defibrillator lead and its corresponding ports at the header of the device. Having only one connection port between the lead and the device reduces the material in the pocket, the risk of lead-to-port mismatch, may lower the risk of lead abrasion, and probably makes the implantation procedure a little easier since only one set screw is required. However, all these conceived benefits are related to convenience rather than to a medical need. After the recent experiences with the possible negative clinical impact of 'minor' changes like simply downsizing a defibrillator lead, a word of caution is warranted. The lead is the weakest part of the defibrillator system, complex in design and undergoing constant stress through movement. It is very hard to predict which issues may evolve over time with the changes in lead design. Does the perceived benefit really outweigh an unpredictable risk in a sensitive medical product like a defibrillator? This article tries to address the possible issues of the new spring contacts instead of set screws, the proximity of the low- and high-voltage connections as well as the inability of adding a pace/sense or an additional shock lead without a special adaptor, and advocates a measured speed in the introduction of this technology.

Keywords

Risk, Pacemaker, Artificial, Reviews, Equipment Design, Defibrillators, Implantable/standards, Equipment Design/standards, Defibrillators, Implantable, Consumer Product Safety, 616, Humans, Industry, Pacemaker, Artificial/standards, ddc: ddc:616

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    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
28
Top 10%
Top 10%
Top 10%
Green
hybrid