Avoiding inappropriate ventricular tachycardia detection due to T-wave oversensing in an implantable cardioverter defibrillator: a novel application of the electrogram width criterion.
Appropriate sensing is an essential function of an implantable cardioverter defibrillator (ICD). T-wave oversensing by an ICD can be a serious problem in some patients, causing overestimation of the heart rate, inappropriate tachyarrhythmia detection and therapy delivery. Decreasing the sensitivity or programming longer refractory periods can sometimes overcome T-wave oversensing, but these measures may interfere with the ability of the ICD to correctly detect tachyarrhythmias. This report proposes a novel application of the electrogram (EGM) width criterion using a recently introduced detection enhancement algorithm intended to improve the specificity of ventricular tachycardia detection, to avoid T-wave oversensing. Based on the course of a case with persistent T-wave oversensing and review of previously published reports, oversensing problems in ICDs and management strategies are discussed.
Cardiac Arrhythmia Unit, University Hospital of Zurich, Raemistr 100, CH-8091, Zurich, Switzerland. firat.duru@dim.usz.ch
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Duru
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Bauersfeld
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Candinas
D017147:Defibrillators, Implantable; D003937:Diagnosis, Differential; D004554:Electric Countershock / Q000295:instrumentation*; D004562:Electrocardiography / Q000379:methods*; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000503:physiopathology