S-ICD screening revisited: do passing vectors sometimes fail?
Pacing Clin Electrophysiol
; 45(2): 182-187, 2022 Feb.
Article
en En
| MEDLINE
| ID: mdl-34881431
ABSTRACT
INTRODUCTION:
Pre-implant ECG screening is performed to ensure that S-ICD recipients have at least one suitable sensing vector, yet cardiac over-sensing remains the commonest cause of inappropriate shock therapy in the S-ICD population. One explanation would be the presence of dynamic variations in ECG morphology that result in variations in vector eligibility.METHODS:
Adult ICD patients had a 24-h ambulatory ECG performed using a digital Holter positioned to record all three S-ICD vectors. Using an S-ICD simulator, automated screening was then performed at one-minute intervals. In vectors with a mean vector score > 100 (the accepted value for a passing vector when screened on a single occasion), the percentage of all screening assessments that passed, eligible vector time (EVT), was calculated. EVT was compared statistically to QRS duration, corrected time to peak T (pTc) and mean vector score.RESULTS:
Ambulatory monitoring was performed in 14 patients (mean age 63.7 ± 5.2 years, 71.4% male) with 42 vectors analysed. In 19 vectors the mean vector score was > 100. Within this "passing" cohort EVT varied between 42.7% and 100%. In 7/19 (37%) the EVT was <75%. A negative correlation was found between QRS duration and EVT (Pearson correlation -.60, p = .007). No correlation was found between EVT and mean vector score or pTc.CONCLUSION:
Vector eligibility is dynamic. When "passing" vectors are subjected to repeated screening, 37% are found to be ineligible, more than a quarter of the time. Further investigation is required to determine the clinical significance of these findings.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Tamizaje Masivo
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Electrocardiografía Ambulatoria
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Muerte Súbita Cardíaca
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Desfibriladores Implantables
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Límite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Año:
2022
Tipo del documento:
Article
País de afiliación:
Reino Unido