T-wave oversensing and inappropriate shocks: a case report.
A 27-year-old male with congenital long QT syndrome, SCN5A mutation experienced recurrent inappropriate exercise-related implantable cardioverter defibrillator (ICD) shocks. This device showed T-wave oversensing with double, which lead to these device discharges. Dynamic T-wave oversensing was reproducibly provoked at exercise treadmill testing and was confirmed as the mechanism leading to double counting. The insertion of a new pacing and sensing lead with increased R-wave amplitude did not solve the problem. Exchanging the existing ICD generator with one capable of automatic sensitivity control (Biotronik, Lexos DR, Biotronik, Berlin, Germany) completely eliminated T-wave oversensing and inappropriate shocks.
Srivathsan
Komandoor
K
Mayo Clinic Arizona-Mayo Clinic Hospital, Cardiovascular Diseases, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.
Scott
Luis R
LR
Altemose
Gregory T
GT
D000328:Adult; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004556:Electric Injuries / Q000209:etiology* / Q000517:prevention & control*; D004562:Electrocardiography / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D006801:Humans