MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION VALITUDE X4 CRT-P; PULSE GENERATOR, PACEMAKER, IMPLANTABLE, WITH CARDIAC RESYNCHRONIZATION (CRT-P)

Model Number U128

Device Problem High impedance (1291)

Patient Problem Insufficient Information (4580)

Event Date 03/07/2021

Event Type  malfunction  

Event Description

It was reported that this cardiac resynchronization therapy pacemaker (crt-p) detected high out-of-range right ventricular (rv) lead pacing impedances.There was no evidence of noise.Technical services (ts) noted they could not rule out an rv lead fracture or possible spring contact issue at this point.The device was reprogrammed to bipolar pace and unipolar sense.The patient will be seen again in a month.No adverse patient effects were reported.The device remains implanted and in service.

Event Description

It was reported that this cardiac resynchronization therapy pacemaker (crt-p) detected high out-of-range right ventricular (rv) lead pacing impedances.There was no evidence of noise.Technical services (ts) noted they could not rule out an rv lead fracture or possible spring contact issue at this point.The device was reprogrammed to bipolar pace and unipolar sense.The patient will be seen again in a month.No adverse patient effects were reported.The device remains implanted and in service.

Manufacturer Narrative

This product has not been returned to boston scientific, and as a result, laboratory analysis could not be conducted.The associated investigation determined that this device exhibited intermittent impedance measurements with no conclusive evidence of a malfunction or inadequate lead-to-device connection; please refer to the description for more information regarding the specific circumstances of this event.Investigation has determined that this type of event is likely the result of an intermittent high impedance condition associated with the device spring contact and lead terminal ring.A design enhancement was implemented in 2020 to stabilize the electrical connection between the spring contact and the lead terminal.

• Brand Name: VALITUDE X4 CRT-P
• Type of Device: PULSE GENERATOR, PACEMAKER, IMPLANTABLE, WITH CARDIAC RESYNCHRONIZATION (CRT-P)
• Manufacturer (Section D): BOSTON SCIENTIFIC CORPORATION; 4100 hamline avenue north; saint paul MN 55112
• MDR Report Key: 11774886
• MDR Text Key: 249007536
• Report Number: 2124215-2021-12196
• Device Sequence Number: 1
• Product Code: NKE
• UDI-Device Identifier: 00802526559402
• UDI-Public: 00802526559402
• Combination Product (y/n): N
• PMA/PMN Number: P030005/S113
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: company representative,health
• Type of Report: Initial,Followup
• Report Date: 07/06/2021

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 05/05/2021
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Lay User/Patient
• Device Expiration Date: 08/21/2019
• Device Model Number: U128
• Device Catalogue Number: U128
• Device Lot Number: 724455
• Was Device Available for Evaluation?: No
• Date Manufacturer Received: 05/27/2021
• Patient Sequence Number: 1
• Patient Age: 73 YR