Inappropriate Discharge of an Implantable Cardioverter Defibrillator During Atrial Flutter and Intermittent Ventricular Antibradycardia Pacing
Article first published online: 20 APR 2007
Journal of Cardiovascular Electrophysiology
Volume 8, Issue 10, pages 1167–1174, October 1997
How to Cite
PETERS, W., KOWALLIK, P., WITTENBERG, G., SCHOLL, C. and MEESMANN, M. (1997), Inappropriate Discharge of an Implantable Cardioverter Defibrillator During Atrial Flutter and Intermittent Ventricular Antibradycardia Pacing. Journal of Cardiovascular Electrophysiology, 8: 1167–1174. doi: 10.1111/j.1540-8167.1997.tb01004.x
- Issue published online: 20 APR 2007
- Article first published online: 20 APR 2007
- Manuscript received 7 January 1997: Accepted for publication 23 June 1997
- implantable cardioverter defibrillator;
- inappropriate discharges;
- integrated bipolar sensing;
- sensing algorithm
Inappropriate Discharge of an ICD. Introduction: Inappropriate discharses of an implantable cardioverter defibrillator (ICD) are troublesome to the patient and sometimes a difficult task for the physician trying; to identify and treat the cause.
Methods and Results: For the first time, we report a mechanism of inappropriate ICD discharges during episodes of atrail flutter with a slow ventricular response and intermittent antibradycardia pacing. The episodes occurred in tow patients and were triggered by the unique sensing alogorithm of the Ventitex Cadence® V-100 in combination with the tripolar CPI Endotak® 072 transvenous defibrillation lead, which provides integrated bipolar sensing.
Conclusion: Besides treatment of the underlying arrhythmia, reprogramming of the device, an electrode position far away from the atria, and true bipolar sensing will enhance the performance of ICD systems with respect to the episodes described here. In addition, more flexible sensing algorithms may. in the future, prevent this overall rare complication.