Document Detail


Inappropriate shock therapy in a heart failure defibrillator.
MedLine Citation:
PMID:  11270706     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 63-year-old male with dilated cardiomyopathy underwent implantation of a "heart failure" defibrillator capable of biventricular pacing. He received an inappropriate shock 5 hours after the procedure. Stored electrograms revealed that during each sinus beat the ventricular channel recorded up to three separate events. These resulted from far-field atrial sensing by the coronary venous lead, appropriate right ventricular sensing, then delayed left ventricular sensing (the result of left bundle branch block). As a consequence of far-field left atrial sensing the two subsequent ventricular electrograms fell within the VF zone. Following an atrial premature beat, VF detection criteria were satisfied and shock therapy delivered. Although coronary venous lead repositioning eliminated far-field atrial sensing, double counting of the widely split right and left ventricular electrograms still occurred during sinus rhythm. Shortening the programmed AV delay resulted in constant biventricular pacing with a single electrogram.
Authors:
T R Betts; S Allen; P R Roberts; J M Morgan
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  24     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-03-28     Completed Date:  2001-07-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  238-40     Citation Subset:  IM    
Affiliation:
Wessex Cardiothoracic Center, Southampton General Hospital, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Cardiac Pacing, Artificial
Cardiomyopathy, Dilated / therapy*
Defibrillators, Implantable*
Electrocardiography
Electrophysiologic Techniques, Cardiac
Equipment Failure
Humans
Male
Middle Aged
Time Factors
Ventricular Fibrillation / diagnosis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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