title: Use of a coronary sinus lead and biventricular ICD to correct a sensing abnormality in a patient with arrhythmogenic right ventricular dysplasia/cardiomyopathy.
abstract: Implantable cardioverter defibrillators (ICDs) are frequently offered to patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). Yet ICDs in these patients may be complicated by poor sensed amplitudes resulting from fatty and fibrous tissue replacement of right ventricular myocardium. We present the case of a patient with ARVD/C who had inappropriate detection of ventricular tachycardia with a single-chamber ICD due to poor sensed right ventricular amplitudes. We discuss how the use of a bipolar coronary sinus lead and a biventricular ICD generator with a novel header configuration solved the problem.
authors.affiliation: Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Bilchick
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Judge
authors.forename: Hugh
authors.initials: H
authors.lastname: Calkins
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Marine
mesh_terms: D000328:Adult; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000628:therapy*; D009202:Cardiomyopathies / Q000628:therapy*; D017147:Defibrillators, Implantable; D003951:Diagnostic Errors; D004562:Electrocardiography; D004868:Equipment Failure; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D017180:Tachycardia, Ventricular / Q000175:diagnosis