title: Epileptic seizure in a patient with an implantable cardioverter-defibrillator: Quo vadis right ventricular lead?
abstract: The case of a 77-year-old man admitted for suspected epileptic seizure is reported. Patient history showed implantation of a single-chamber implantable cardioverter-defibrillator (ICD) after cardiac arrest in 2007 with replacement in 2012 due to battery depletion; the patient reported no previous syncope, unconsciousness or seizures. Interrogation records of the ICD showed five ventricular tachyarrhythmia episodes that corresponded to the "seizure". Further examination revealed incorrect position of the RV-lead. Diagnosis was a provoked epileptic seizure due to undersensing of ventricular tachycardia because of improper ICD lead implantation in the coronary sinus. Treatment consisted of implantation of a new device with an additional ICD lead into the right ventricle.
authors.affiliation: Dept. of Cardiology and Angiology, Medizinische Klinik III, St. Franziskus-Hospital Münster, Hohenzollernring 72, 48145, Münster, Germany. horst.wedekind@sfh-muenster.de.
authors.forename: Horst
authors.initials: H
authors.lastname: Wedekind
authors.affiliation: Dept. of Cardiology and Angiology, Medizinische Klinik III, St. Franziskus-Hospital Münster, Hohenzollernring 72, 48145, Münster, Germany.
authors.forename: Andrey
authors.initials: A
authors.lastname: Rozhnev
authors.affiliation: Dept. of Cardiology and Angiology, Medizinische Klinik III, St. Franziskus-Hospital Münster, Hohenzollernring 72, 48145, Münster, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Kleine-Katthöfer
authors.affiliation: Dept. of Cardiology, Schüchtermann-Klinik, 49214, Bad Rothenfelde, Ulmenallee 5-11, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kranig
mesh_terms: D000368:Aged; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D020878:Device Removal; D003951:Diagnostic Errors / Q000009:adverse effects*; D004556:Electric Injuries / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000517:prevention & control; D004827:Epilepsy / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control; D004868:Equipment Failure; D006801:Humans; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000517:prevention & control
keywords: Coronary sinus; Defibrillators, implantable; Epilepsy; Tachycardia, ventricular; Undersensing