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Prevalence of sensing abnormalities in dual chamber implantable cardioverter defibrillators.
Saeed, Mohammad; Jin, Anna; Pontone, Gregory; Higgins, Steve; Gold, Michael; Harari, David; Nunley, Steven; Link, Mark S; Homoud, Munther K; Estes, N A Mark; Wang, Paul J.
Afiliação
  • Saeed M; University of Texas Medical Branch, Galveston, TX 77555-0553, USA. m.saeed@utmb.edu
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.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Desfibriladores Implantáveis Tipo de estudo: Clinical_trials / Diagnostic_studies / Evaluation_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / 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

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Desfibriladores Implantáveis Tipo de estudo: Clinical_trials / Diagnostic_studies / Evaluation_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / 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