Tribology of Insulation Materials Within Implantable Cardioverter-Defibrillator Leads

Insulation wear in implanted cardioverter-defibrillator (ICD) leads may result in serious failure modes, including inappropriate or missing therapy. Tests performed on a custom apparatus developed to simulate in-vivo loading showed order of magnitude differences in specific wear rate between materials commonly used in ICD leads. Wear rates were also dependent on load, suggesting that design and application differences may further differentiate performance between materials.