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An unusual cause for inappropriate defibrillator shock.
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  • Debabrata Bera,
  • Ayan Kar,
  • Biswajit Majumder,
  • Arup Kumar Ghosh,
  • Debdutta Bhattacharyya
Debabrata Bera
Rabindranath Tagore International Institute of Cardiac Sciences

Corresponding Author:debu2000pgi@gmail.com

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Ayan Kar
Rabindranath Tagore International Institute of Cardiac Sciences
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Biswajit Majumder
RG Kar Medical College
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Arup Kumar Ghosh
Rabindranath Tagore International Institute of Cardiac Sciences
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Debdutta Bhattacharyya
Rabindranath Tagore International Institute of Cardiac Sciences
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Abstract

A 50-year-old lady with dilated cardiomyopathy and scar VT underwent single chamber implantable cardioverter-defibrillator (ICD, Medtronic Ltd, Evera XT VR, DVBB2D1) implantation 2 months back. A Sprint Quattro secure 6947 DF1 dual coil lead was placed at RV apex. Now, she presents with an episode of ICD shock while having breakfast. The device interrogation shows a 36 J shock in VF zone (Fig 1A). However, the stored electrograms (EGM) reveal distinct QRS complexes in the far-field EGM; hence, suggesting the shock is related to oversensing. Fig 1B shows 2 panels of another recent episode. Fortunately, there was aborted therapy as there was intermittent resolution of the oversensing. The lead impedance was normal but threshold was high. Is it possible to predict the reason for the oversensing from the EGM and how to troubleshoot?
Jul 2022Published in Indian Pacing and Electrophysiology Journal. 10.1016/j.ipej.2022.07.006