It was reported that this patient felt faint.Technical services (ts) reviewed device episode data of this cardiac resynchronization therapy defibrillator (crt-d) and found that there was noise on the right ventricular (rv) lead and shock channels and oversensing that resulted in asystole of two seconds and five seconds.This patient is dependent on pacing.In clinic, isometric testing was performed, and the noise was reproduced.It was noted that the right atrial (ra) lead was dislodged which was confirmed by x-ray.It was also noted that the was a spike of rv impedance prior to stored episode of noise.Ts discussed reprogramming options and recommended testing of rv lead and revision of ra lead.No additional adverse patient effects were reported.Currently, this crt-d system remains in service.
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