[186786365]
Patient presented with high lead impedance and low output current. It was also noted that the patient had a lack of efficacy with the device that started at the same time as the high lead impedance. The physician's office does not know the reason for the high lead impedance, or if there was a gradual increase in impedance. The patient later reported that she was attacked by a dog prior to the high impedance reading. The patients device was later interrogated and system diagnostics showed high lead impedance and low output current. The patients output current was reduced and system diagnostics were again run. The output current was ok; however, high lead impedance was again seen. Ap and lateral chest and neck x-ray images were received. The generator was located in the upper left chest. Due to the angle and quality of the image, it cannot be assessed if the connector pin is fully past the second connector block or if the filter feedthru wires were intact. The lead was visualized in the chest and neck. The lead appears to be routed behind the generator. The lead wires appear to be intact at the connector pin. No sharp angles were observed in the lead. The lead was assessed for fractures and no gross fractures or discontinuities were noted. Based on the x-rays received, the cause for the high impedance cannot be determined at this time. Note that the presence of a micro-fracture and/or a lead discontinuity could not be ruled out in the portion of the lead that is not visible in the provided images. No known relevant surgical intervention has occurred to date. No additional or relevant information has been received to date.
Patient Sequence No: 1, Text Type: D, B5