Document Detail


Ventricular oversensing: a study of 101 patients implanted with dual chamber defibrillators and two different lead systems.
MedLine Citation:
PMID:  12685142     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Modern dual chamber ICD systems are able to overcome various sensing problems. However, improvement of their performance is still required. The aim of this study was to assess the sensing function in 101 consecutive patients (84 men, 17 women; mean age 63 +/- 12 years; mean follow-up 24 +/- 4 months) implanted with dual chamber defibrillators and integrated (IB) or dedicated bipolar (DB) lead systems. Follow-up data were analyzed for the presence of ventricular oversensing. Oversensing occurred in 25 (25%) patients, significantly more frequent in patients implanted with IB compared to DB lead systems (21/52 vs 4/49, P = 0.0002). Patients with cardiomyopathies (CMs) were more prone to sensing malfunctions than patients with no CM (12/30 vs 13/71, P = 0.04). T wave oversensing (n = 14), respirophasic ventricular oversensing (n = 4), and P wave oversensing (n = 6) were the most common pitfalls of ventricular sensing. P wave oversensing was unique to the IB lead system. CT scans performed in these patients disclosed the position of the RV coil to be proximal to the tricuspid area. Four patients received inappropriate ICD shocks due to oversensing. In all but two patients who received lead revision, oversensing was resolved by noninvasive means. In conclusion: (1) ventricular oversensing is a common problem occurring in up to 25% of patients with dual chamber ICDs; (2) P wave oversensing is a ventricular sensing problem affecting function of 11% of dual chamber devices with IB lead systems; (3) IB leads are significantly more susceptible to T wave and P wave oversensing than DB leads; and (4) patients with cardiomyopathies are more prone to oversensing than patients with other heart diseases.
Authors:
Slawomir Weretka; Jochen Michaelsen; Ruediger Becker; Christoph A Karle; Frederik Voss; Thomas Hilbel; Brigitte R Osswald; Malte L Bahner; Julia C Senges; Wolfgang Kuebler; Wolfgang Schoels
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  26     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-04-10     Completed Date:  2003-06-25     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:  65-70     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Electrophysiology, University Hospital Heidelberg, Bergheimerstr. 58, 69115 Heidelberg, Germany. weretka@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Cardiomyopathies / physiopathology
Defibrillators, Implantable*
Electrocardiography*
Electrodes, Implanted
Equipment Design
Equipment Failure
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Time Factors

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


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