A Case of an Inappropriate Implantable Cardioverter Defibrillator Shock Delivery Coincident with a Decline in the Biventricular Pacing Rate due to T-wave Oversensing

DOI 13 References
  • Sasaki Kengo
    Division of Clinical Engineering, Sendai Kousei Hospital
  • Mori Shumpei
    Division of Cardiology, Cardiovascular Center, Sendai Kousei Hospital
  • Kanno Hakudou
    Division of Clinical Engineering, Sendai Kousei Hospital
  • Suzuki Tomohiro
    Division of Clinical Engineering, Sendai Kousei Hospital
  • Chiba Takeshi
    Division of Clinical Engineering, Sendai Kousei Hospital
  • Monma Ryuichiro
    Division of Clinical Engineering, Sendai Kousei Hospital
  • Ogoshi Noboru
    Division of Clinical Engineering, Sendai Kousei Hospital
  • Osai Norichika
    Division of Cardiology, Cardiovascular Center, Sendai Kousei Hospital
  • Kaneko Umihiko
    Division of Cardiology, Cardiovascular Center, Sendai Kousei Hospital
  • Takizawa Kaname
    Division of Cardiology, Cardiovascular Center, Sendai Kousei Hospital
  • Inoue Naoto
    Division of Cardiology, Cardiovascular Center, Sendai Kousei Hospital
  • Meguro Taiichiro
    Division of Cardiology, Cardiovascular Center, Sendai Kousei Hospital

Bibliographic Information

Other Title
  • T波オーバーセンシングを回避することで不適切作動によるショック通電の消失および両室ペーシング率の改善を認めた1例

Search this article

Abstract

T-wave oversensing results in over-counting ventricular sensed events, thus satisfying the rate criterion and sometimes leading to inappropriate shocks in patients with implantable cardioverter defibrillator (ICD). ICD shocks are associated with worse mental health, impaired quality of life, and increased risk of mortality.<BR>In patients with cardiac resynchronization therapy device with defibrillator (CRT-D), T-wave oversensing can also lead to a decline in the biventricular pacing rate.<BR>Here, we present a case of a 70-year-old male who underwent CRT-D implantation and experienced an inappropriate shock three months after the operation. At this time, the biventricular pacing rate recorded in the pacing summary decreased from 99% to 75%. Intracardiac electrocardiogram revealed T-wave oversensing in the right ventricular lead as the cause of both unfavorable events. Although we could not avoid T-wave oversensing by adjusting the threshold of ventricular sensitivity, customizing frequency filter characteristics successfully resolved it. Inappropriate shock has never recurred and the biventricular pacing rate has been kept above 98% for the subsequent 22 months.

Journal

References(13)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top