Implantable cardioverter defibrillator sensing failure due to endocardial R wave electrical alternans.
A 71-year-old patient underwent routine single-chamber implantable cardioverter defibrillator (ICD) generator replacement. During defibrillation threshold testing, ventricular tachycardia was induced but the ICD failed twice to properly detect the tachycardia due to endocardial R wave alternans and sensing of every other beat. The problem was resolved by inserting a separate sensing/pacing lead positioned further away from the existing ICD lead.
Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
Krit
K
Jongnarangsin
Theofanie
T
Mela
D000368:Aged; D017147:Defibrillators, Implantable / Q000009:adverse effects; D004562:Electrocardiography; D004868:Equipment Failure; D019544:Equipment Failure Analysis; D006801:Humans; D008297:Male; D012680:Sensitivity and Specificity; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000503:physiopathology*