title: Incidence and causes of inappropriate detection and therapy by implantable defibrillators of cardioversion in patients with ventricular tachyarrhythmia.
abstract: BACKGROUND
  Implantable cardioverter defibrillator (ICD) is the only effective therapy in patients with life threatening ventricular arrhythmias. Inappropriate detection and therapy by ICDs are the most common causes of side effects that affect the quality of life in ICD recipients. This study evaluated the incidence and causes of inappropriate detection and therapy by ICDs in patients in our hospital.
  
  
  METHODS
  From January 2000 to December 2005, fifty patients who received ICD implantation for ventricular arrhythmias for prevention of sudden cardiac death were evaluated in this study. Each ICD was programmed using clinical arrhythmic and cardiac data of the patient before discharge. Patients were followed up by standard schedule after implantation and all data retrieved from each device were collected and saved for further analysis.
  
  
  RESULTS
  No arrhythmic event was detected in 12/50 (24%) patients during the period of follow-up. Among the remaining patients, 11 (22%) experienced inappropriate detections and therapies during follow-up in this study. ICD detected 383 ventricular tachyarrhythmia (VT) and 108 ventricular fibrillation (VF) episodes and delivered 678 therapies. In VT group, ICD delivered 413 antitachycardiac pacings (ATPs) and 118 shocks, among which 78 ATPs and 9 shocks were initiated by 55/383 (14.3%) inappropriate detections. In VF group ICD delivered 147 shocks, among which 56 shocks were initiated by 28/108 (26.9%) inappropriate detections. Overall, more than 50% of these episodes were caused by atrial fibrillation (AF) with rapid ventricular response, followed by electromagnetic or myopotential interference. In addition, most inappropriate therapies occurred within one year after ICD implantation.
  
  
  CONCLUSIONS
  About one fifth of patients experienced ICD inappropriate detection and therapy after implantation. The main cause was AF with rapid ventricular response, followed by electromagnetic or myopotential interference.
authors.affiliation: Centre of Arrhythmia Diagnosis and Treatment, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Ruo-han
authors.initials: RH
authors.lastname: Chen
authors.forename: Ke-ping
authors.initials: KP
authors.lastname: Chen
authors.forename: Fang-zheng
authors.initials: FZ
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Hua
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
authors.forename: Shu
authors.initials: S
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000628:therapy*