Prevalence of sensing abnormalities in dual chamber implantable cardioverter defibrillators.
Ann Noninvasive Electrocardiol
; 8(3): 219-26, 2003 Jul.
Article
em En
| MEDLINE
| ID: mdl-14510657
BACKGROUND: The clinical efficacy of ICD therapy depends on accurate sensing of intracardiac signals and sensing algorithms. We investigated the occurrence of sensing abnormalities in patients with dual chamber ICDs. METHODS: The study group consisted of all patients with dual chamber ICDs enrolled in the LESS trial and patients implanted with dual chamber ICDs at a single center between January 1997 and July 2000. Electrograms of spontaneous ventricular arrhythmias requiring device intervention were analyzed. RESULTS: A total of 48 patients met the criteria for enrollment. Among the 244 episodes, 215 (88%) were due to ventricular tachycardia and 29 (12%) were due to ventricular fibrillation. Overall undersensing was infrequent with 12 (20%) patients exhibiting on average 2.2 undersensed beats during 26 episodes of ventricular arrhythmias. There was no delay in therapy due to undersensing. Oversensing occurred in 5 (10%) patients resulting in 13 (2.7%) episodes of inappropriate therapy. None of the patients had any lead abnormalities and oversensing resolved after device reprogramming in 4 patients while 1 patient required a separate rate sensing lead. Among patients with oversensing, 4 out of 5 were pacing before the index event while among patients with no oversensing only 5 out of 42 were pacing (P<0.001). CONCLUSIONS: Dual chamber ICDs demonstrate outstanding accuracy of sensing. However, because of the selection of patient population requiring more frequent pacing, oversensing occurs with a significant frequency. Meticulous evaluation in such patients is necessary to minimize the likelihood of oversensing and inappropriate shocks.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Desfibriladores Implantáveis
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
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Evaluation_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Ann Noninvasive Electrocardiol
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2003
Tipo de documento:
Article
País de afiliação:
Estados Unidos
País de publicação:
Estados Unidos