Inappropriate Discharges by Fourth Generation Implantable Cardioverter Defibrillators in Patients With Ventricular Arrhythmias.

Washizuka, Takashi; Chinushi, Masaomi; Tagawa, Masatoshi; Kasai, Hajime; Watanabe, Hiroshi; Hosaka, Yukio; Yamashita, Fumio; Furushima, Hiroshi; Abe, Akira; Hayashi, Jun‐Ichi; Aizawa, Yoshifusa

doi:10.1253/jcj.65.927

Cited by 23 publications

(26 citation statements)

References 13 publications

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“…We also observed a high incidence of inappropriate shocks (44%), mainly caused by atrial fibrillation and sinus tachycardia. This is well in accordance with other studies where up to 40% inappropriate discharge rates were observed even with fourth generation ICDs [23]. The addition of an anti-arrhythmic drug to decrease the incidence of inappropriate shocks was required in this group.…”

Section: Discussionsupporting

confidence: 92%

Recurrent cardiac events in patients with idiopathic ventricular fibrillation, excluding patients with the Brugada syndrome

Champagne

Geelen

Philippon³

et al. 2005

BMC Med

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Section: Discussionsupporting

confidence: 92%

Recurrent cardiac events in patients with idiopathic ventricular fibrillation, excluding patients with the Brugada syndrome

Champagne

Geelen

Philippon³

et al. 2005

BMC Med

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“…Dedicated bipolar leads are more susceptible to T-wave oversensing, probably because of greater variations in R-wave amplitude, 3,4 and this could be of extreme importance in patients with hypertrophic cardiomyopathy, dilated cardiomyopathy, cardiac sarcoidosis, long-QT syndrome, familial short-QT syndrome, BrS, and hyperkalemia, in whom T-wave oversensing has been reported to be more frequent. [7][8][9][10][11] The cause of this discrepancy has not been clearly elucidated. Some authors concentrate on the measurement properties of the lead system and argue that the quality of the signals recorded by dedicated and integrated bipolar configurations is different.…”

Section: Discussionmentioning

confidence: 99%

T-Wave Oversensing in Patients With Brugada Syndrome: True Bipolar Versus Integrated Bipolar Implantable Cardioverter Defibrillator Leads

Rodríguez‐Mañero

Asmundis

Sacher

et al. 2015

Circ: Arrhythmia and Electrophysiology

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Background-It is thought that dedicated bipolar are more susceptible to T-wave oversensing when compared with integrated bipolar leads. This could be of extreme importance in patients with Brugada syndrome (BrS) because T-wave oversensing in this population is more frequent when compared with other implantable cardioverter defibrillator (ICD) recipients without BrS. We aimed to compare the incidence of T-wave oversensing in patients with BrS according to the type of lead (integrated bipolar versus true/dedicated bipolar). Methods and Results-All patients diagnosed with BrS with an ICD implant in 10 tertiary hospitals between 1993 and 2013were included in the study. A total of 480 patients were included (mean age, 45.6±14 years). During a mean follow-up of 74.9±51.7 months (median, 69; range, 2-236), 28 patients had T-wave oversensing (5.8%), leading to inappropriate shock in 18 (3.8%). All these events occurred in patients with true bipolar ICD leads (P=0.01) and in 2 patients it was solved instantaneously by changing the configuration from a dedicated to an integrated bipolar sensing configuration. In the stepwise multivariate models, only integrated bipolar ICD leads (hazard ratio, 0.34; 95% confidence interval, 0.171-0.675; P=0.002) was independent predictor of non-T-wave oversensing. Conclusions-T-wave oversensing is a potential reason of inappropriate shocks in patients with BrS receiving ICDs. In the vast majority it can be solved by reprogramming. However, in some patients it still requires invasive intervention. Importantly, incidence is significantly lower using an integrated bipolar lead system when compared with a dedicated bipolar lead system and hence the latter should be routinely used in BrS cases. Rodríguez-Mañero et al T-Wave Oversensing in Brugada Syndrome 793oversensing when compared with integrated bipolar leads, probably because of greater variations in R-wave amplitude. 3,4 This could be of extreme importance in BrS because T-wave oversensing in this population has been reported to be more frequent. 5We aimed to compare the incidence of T-wave oversensing in patients with BrS according to the type of ICD lead (integrated bipolar [coil plus distal lead electrode] versus dedicated bipolar). MethodsAll patients diagnosed with BrS and implanted with an ICD in 10 tertiary hospitals between 1993 and 2013 were included in the study. The diagnosis was made after an episode of aborted sudden cardiac arrest, during evaluation of syncope, in asymptomatic patients with a suggestive ECG pattern recorded during routine examination, or as a consequence of familial screening after the diagnosis of BrS in a family member. This registry was approved by the institutional review committee, and the subjects gave informed consent.Patients were included in the study if they had a type 1 Brugada pattern on ECG at baseline on at least 1 occasion or after provocation with a class I antiarrhythmic drug (determined by its availability in the participating hospitals; ajmaline, pilsicainide, flecainide, or procainamida...

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“…Although infrequent today, T wave oversensing constitutes a substantial proarrhythmic risk 9 . The most common causes are atrial fibrillation, sinus tachycardia, other supraventricular tachycardias, and R wave oversensing 10–15 …”

Section: Discussionmentioning

confidence: 99%

Congenital Short QT Syndrome and Implantable Cardioverter Defibrillator Treatment:

Schimpf

Wolpert

Bianchi³

et al. 2003

Cardiovasc electrophysiol

164

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The congenital short QT syndrome constitutes a new clinical entity with an increased risk for sudden cardiac death. Currently, ICD treatment is the only therapeutic option. In patients with short QT interval and implanted ICD, increased risk for inappropriate therapy is inherent due to the detection of short-coupled and prominent T waves. Careful testing of ICD function and adaptation of sensing levels and decay delays without sacrificing correct arrhythmia detection are essential.

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Inappropriate Discharges by Fourth Generation Implantable Cardioverter Defibrillators in Patients With Ventricular Arrhythmias.

Cited by 23 publications

References 13 publications

Recurrent cardiac events in patients with idiopathic ventricular fibrillation, excluding patients with the Brugada syndrome

Recurrent cardiac events in patients with idiopathic ventricular fibrillation, excluding patients with the Brugada syndrome

T-Wave Oversensing in Patients With Brugada Syndrome: True Bipolar Versus Integrated Bipolar Implantable Cardioverter Defibrillator Leads

Congenital Short QT Syndrome and Implantable Cardioverter Defibrillator Treatment:

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