title: Variability of atrial sensing during exercise in a patient with a dual chamber ICD caused inappropriate ICD discharges.
abstract: We present the case of a patient with a dual chamber implantable cardioverter defibrillator (ICD) who experienced inappropriate ICD discharges during exercise. Interrogation of the ICD revealed intermittent atrial undersensing during exercise that was responsible for the erroneous classification by the ICD of sinus tachycardia as ventricular tachycardia. Monitoring of the intracardiac electrograms and Marker Channels during an exercise test confirmed a marked decrease in P wave amplitude during exercise. By increasing the atrial sensitivity setting the problem was resolved.
authors.affiliation: Section of Electrophysiology, Hackensack University Medical Center, NJ 07601, USA.
authors.forename: T V
authors.initials: TV
authors.lastname: Glotzer
authors.forename: G A
authors.initials: GA
authors.lastname: Radoslovich
authors.forename: J
authors.initials: J
authors.lastname: Neglia
authors.forename: J M
authors.initials: JM
authors.lastname: Zimmerman
mesh_terms: D000328:Adult; D002304:Cardiac Pacing, Artificial / Q000379:methods; D017147:Defibrillators, Implantable / Q000145:classification; D015716:Electrocardiography, Ambulatory; D004868:Equipment Failure; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D006325:Heart Atria; D006801:Humans; D008297:Male; D013616:Tachycardia, Sinus / Q000175:diagnosis; D017180:Tachycardia, Ventricular / Q000175:diagnosis