title: Left and Right Ventricle Leads Switch as a Solution for TWave Oversensing - How a Good Idea Turned Out Bad.
abstract: A 50-year-old male with a CRT defibrillator received inappropriate ICD shocks due to T-wave oversensing. Decreasing the sensitivity to avoid T wave oversensing was not an option due to a suboptimal R-wave sensing amplitude. We decided to re-plug the LV lead in the RV port and the RV lead in the LV port. This however led to intermittent phrenic nerve stimulation due to mandatory bipolar (tip-ring) or unipolar (tip-can) pacing on the LV-lead from the RV port. Re-intervention was necessary with the implantation of an additional pacing/sensing RV lead. A software programmable choice to switch sensing and tachycardia detection from RV to LV lead could be a valuable feature in future CRT devices.
authors.affiliation: Department of Cardiology, Glorieux General Hospital, Ronse, Belgium ; Department of Cardiology, OLV General Hospital, Aalst, Belgium ; Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Bsn
authors.initials: B
authors.lastname: Alzand
authors.affiliation: Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Tje
authors.initials: T
authors.lastname: Phlips
authors.affiliation: Department of Cardiology, University Hospitals Leuven, Leuven, Belgium ; Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
authors.forename: R
authors.initials: R
authors.lastname: Willems
keywords: CRT-D; T-wave ovesensing; inappropriate socks