title: Case report: inappropriate discharge of an implantable cardioverter-defibrillator caused by the combined count criterion.
abstract: We describe a rare case of an inappropriate defibrillator discharge during a sinus tachycardia with single fast sensed beats fulfilling the ventricular fibrillation rate criterion, activating the "combined count criterion," although the prevalent sinus tachycardia was inside a ventricular tachycardia rate zone, programmed to monitor only mode. The "combined count criterion" is a safety feature that ensures defibrillation therapy in case of a tachyarrhythmia inside the ventricular tachycardia detection zone, that is temporarily crossing the ventricular fibrillation detection rate. This case reports shows that there is a low but unpredictable risk of device therapy even in a zone programmed to monitor only mode. This phenomenon should be considered when a monitor only zone is installed for revelation of slower tachyarrhythmias.
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: S
authors.initials: S
authors.lastname: Spehl
authors.forename: T
authors.initials: T
authors.lastname: Korte
authors.forename: B
authors.initials: B
authors.lastname: Lüderitz
mesh_terms: D000328:Adult; D017147:Defibrillators, Implantable; D004867:Equipment Design; D004868:Equipment Failure; D004869:Equipment Safety; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D005082:Physical Exertion / Q000502:physiology; D012307:Risk Factors; D013616:Tachycardia, Sinus / Q000628:therapy; D014693:Ventricular Fibrillation / Q000628:therapy