Left and Right Ventricle Leads Switch as a Solution for T Wave Oversensing - How a Good Idea Turned Out Bad

A 50-year-old male with a CRT defibrillator received inappropriate ICD shocks due to T-wave oversensing. Decreasing the sensitivity to avoid T wave oversensing was not an option due to a suboptimal R-wave sensing amplitude. We decided to re-plug the LV lead in the RV port and the RV lead in the LV p...

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Detalles Bibliográficos
Autores principales: Alzand, BSN, Phlips, TJE, Willems, R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Heart Rhythm Society 2014
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4032783/
https://www.ncbi.nlm.nih.gov/pubmed/24920871
Descripción
Sumario:A 50-year-old male with a CRT defibrillator received inappropriate ICD shocks due to T-wave oversensing. Decreasing the sensitivity to avoid T wave oversensing was not an option due to a suboptimal R-wave sensing amplitude. We decided to re-plug the LV lead in the RV port and the RV lead in the LV port. This however led to intermittent phrenic nerve stimulation due to mandatory bipolar (tip-ring) or unipolar (tip-can) pacing on the LV-lead from the RV port. Re-intervention was necessary with the implantation of an additional pacing/sensing RV lead. A software programmable choice to switch sensing and tachycardia detection from RV to LV lead could be a valuable feature in future CRT devices.

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