title: Electrical proarrhythmia: induction of inappropriate atrial therapies due to far-field R wave oversensing in a new dual chamber defibrillator.
abstract: This case report describes delivery of atrial therapies during a sinus tachycardia in a new dual chamber implantable cardioverter defibrillator inappropriately caused by far-field oversensing of ventricular beats in the atrial channel. Upon classification of the PR interval pattern, the rate criterion for an atrial tachycardia was fulfilled, and the device initiated high-frequency burst pacing as the first stage of programmed tiered atrial therapies. Atrial fibrillation subsequently was induced by high-frequency burst pacing, and eventually a programmed 10-J shock was delivered for successful termination of atrial fibrillation. The phenomenon of far-field oversensing of ventricular beats could be repeatedly observed during exercise testing and abolished by decreasing the atrial sensitivity.
authors.affiliation: Department of Medicine-Cardiology, University of Bonn, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Wolpert
authors.forename: W
authors.initials: W
authors.lastname: Jung
authors.forename: C
authors.initials: C
authors.lastname: Scholl
authors.forename: S
authors.initials: S
authors.lastname: Spehl
authors.forename: J
authors.initials: J
authors.lastname: Cyran
authors.forename: B
authors.initials: B
authors.lastname: Lüderitz
mesh_terms: D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004562:Electrocardiography; D004867:Equipment Design; D004868:Equipment Failure; D006300:Health Services Misuse; D006801:Humans; D008297:Male; D008875:Middle Aged; D013616:Tachycardia, Sinus / Q000628:therapy*