title: Inappropriate Shock Due to T-Wave Oversensing by a Subcutaneous ICD after Alcohol Septal Ablation for Hypertrophic Cardiomyopathy.
abstract: A 53-year-old female patient with hypertrophic obstructive cardiomyopathy (HOCM) was admitted for alcohol septal ablation (ASA). A subcutaneous internal cardioverter defibrillator (S-ICD) was implanted for primary prevention. After ASA, the patient developed a right bundle branch block, and the S-ICD delivered a total of five inappropriate shocks due to T-wave oversensing (TWOS). TWOS is a relatively frequent cause of inappropriate shocks in S-ICD patients. After invasive treatment for HOCM, there is a risk of developing intraventricular conduction delay and subsequent changes in QRS and T-wave morphology. This should be taken into consideration when ICD indication is evaluated in HOCM patients.
authors.affiliation: Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands.
authors.forename: Vincent F
authors.initials: VF
authors.lastname: Van Dijk
authors.affiliation: Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands.
authors.forename: Max
authors.initials: M
authors.lastname: Liebregts
authors.affiliation: Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands.
authors.forename: Justin G L M
authors.initials: JG
authors.lastname: Luermans
authors.affiliation: Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands.
authors.forename: Jippe C
authors.initials: JC
authors.lastname: Balt
mesh_terms: D055011:Ablation Techniques / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004556:Electric Injuries / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006346:Heart Septum / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000431:Ethanol
keywords: defibrillation - ICD; electrocardiogram; inappropriate shock