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Europace 2001 3(1):80-84; doi:10.1053/eupc.2000.0145
© 2001 by European Society of Cardiology
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CASE REPORT

Avoiding inappropriate ventricular tachycardia detection due to T-wave oversensing in an implantable cardioverter defibrillator: a novel application of the electrogram width criterion

F. Duru, U. Bauersfeld and R. Candinas

Cardiac Arrhythmia Unit, University Hospital of Zurich Zurich, Switzerland

Appropriate sensing is an essential function of an implantable cardioverter defibrillator (ICD). T-wave oversensing by an ICD can be a serious problem in some patients, causing overestimation of the heart rate, inappropriate tachyarrhythmia detection and therapy delivery. Decreasing the sensitivity or programming longer refractory periods can sometimes overcome T-wave oversensing, but these measures may interfere with the ability of the ICD to correctly detect tachyarrhythmias. This report proposes a novel application of the electrogram (EGM) width criterion using a recently introduced detection enhancement algorithm intended to improve the specificity of ventricular tachycardia detection, to avoid T-wave oversensing. Based on the course of a case with persistent T-wave oversensing and review of previously published reports, oversensing problems in ICDs and management strategies are discussed.

Key Words: T-wave oversensing, implantable cardioverter defibrillator, ventricular tachycardia, detection enhancement, electrogram width criterion

Correspondence: Firat Duru, Cardiac Arrhythmia Unit, University Hospital of Zurich, Raemistr. 100, CH-8091, Zurich, Switzerland. E-mail: firat.duru{at}dim.usz.ch


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