Potential hazards of fixed gain sensing and arrhythmia reconfirmation for implantable cardioverter defibrillators.
Appropriate sensing of ventricular tachycardia (VT) and ventricular fibrillation (VF) is of paramount importance for safety of patients with implanted cardioverter defibrillators ICDs). Recently, the GuardianR ATP 4210. a new third generation ICD that uses programmable but fixed sensing during sinus...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 16; no. 5; pp. 1070 - 1080 |
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| Autores principales: | , , |
| Formato: | Journal Article |
| Publicado: |
Wiley-Blackwell
May1993
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106037470&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106037470 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: May1993 vid: 16 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106037470 2009412691 NLM7685888 106037470 ppf: 1070 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Potential hazards of fixed gain sensing and arrhythmia reconfirmation for implantable cardioverter defibrillators. aug: au: Singer I Adams L Austin E sug: ab: Appropriate sensing of ventricular tachycardia (VT) and ventricular fibrillation (VF) is of paramount importance for safety of patients with implanted cardioverter defibrillators ICDs). Recently, the GuardianR ATP 4210. a new third generation ICD that uses programmable but fixed sensing during sinus rhythm and doubles its sensitivity settings when VF is detected, to a maximum programmable sensitivity of 1 mV, has been tested in phase I and II clinical trials. A reconfirmation algorithm of this ICD confirms the presence of VT or VF prior to therapy. This case report describes undersensing of VF in a patient with the GuardianR ATP 4210 at the maximum programmed sensitivity of 1 mV. Inappropriate episodes of asystole and prolonged bradycardias were also observed in this patient due to shortcomings in the reconfirmation algorithm design. Reoperation was required, with positioning of a new endocardial sensing lead to correct the undersensing of VF. This, however, did not correct asystolic pauses following antitachycardia pacing or spontaneous tachycardio termination prior to therapy. This case report highlights the hazards of fixed gain sensing for implantable ICDs and a potential limitation of a specific tachyarrhythmia reconfirmation algorithm used in this device. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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