title: ICD discrimination of SVT versus VT with 1:1 V-A conduction: A review of the literature.
abstract: Inappropriate ICD shocks are associated with increased mortality. They also impair patients' quality of life, increase hospitalizations, and raise health-care costs. Nearly 80% of inappropriate ICD shocks are caused by supraventricular tachycardia. Here we report the case of a patient who received a single-lead dual-chamber sensing ICD for primary prevention of sudden cardiac death and experienced inappropriate ICD shocks. V-A time, electrogram morphology, and response to antitachycardia pacing suggested atrioventricular nodal reentry tachycardia, which was confirmed in an electrophysiology study. Inspired by this case, we performed a literature review to discuss mechanisms for discrimination of supraventricular tachycardia with 1:1 A:V relationship from ventricular tachycardia with 1:1 retrograde conduction.
authors.affiliation: Cardiovascular Division, Department of Medicine, University of Miami, Miller School of Medicine, Miami, USA.
authors.forename: Rhanderson N
authors.initials: RN
authors.lastname: Cardoso
authors.affiliation: Cardiovascular Division, Department of Medicine, University of Miami, Miller School of Medicine, Miami, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Healy
authors.affiliation: Cardiovascular Division, Department of Medicine, University of Miami, Miller School of Medicine, Miami, USA.
authors.forename: Juan
authors.initials: J
authors.lastname: Viles-Gonzalez
authors.affiliation: Cardiovascular Division, Department of Medicine, University of Miami, Miller School of Medicine, Miami, USA.
authors.forename: James O
authors.initials: JO
authors.lastname: Coffey
keywords: Atrioventricular nodal reentrant tachycardia; Implantable cardioverter defibrillator; Inappropriate shock; Rhythm discrimination algorithms; Supraventricular tachycardia