Europace Advance Access originally published online on September 26, 2007
Europace 2007 9(11):1041-1047; doi:10.1093/europace/eum195
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ICDS
Ventricular oversensing in 518 patients with implanted cardiac defibrillators: incidence, complications, and solutions
Medical Clinic II, Department of Internal Medicine and Cardiology, University of Technology Dresden, Fetscherstr. 76, 01307 Dresden, Germany
The present study evaluates the incidence of various complications in implanted cardiac defibrillators (ICD) therapy due to ventricular oversensing (VO) and its complications. From June 1998 to May 2005, we retrospectively screened 518 patients (1085.6 patient years) for the occurrence of VO episodes (441 male, 77 female). The overall incidence was 7.3% (n = 38) with inappropriate shock deliveries accounting for 2.3% (n = 12). All VO episodes were caused by either T-wave oversensing (n = 10), myopotentials (n = 8), electrode failure (n = 5), interference with electromagnetic fields (n = 3), double-counting (n = 4), pacemaker interactions (n = 2), or others (n = 2). There were five life-threatening events due to inappropriate ICD reaction. In eight (22%) cases, ICD reprogramming was able to avoid further oversensing episodes (e.g. adaptation of sensitivity, T-wave suppression feature), 13 (35%) patients had to undergo invasive procedures (e.g. electrode replacing) to suppress VO, 16 (43%) were told to avoid the trigger situation, and one demanded to deactivate all ICD therapies because of inappropriate shock delivery. Our data demonstrate that VO is a rare complication, but might lead to life-threatening events. In most cases, VO episodes could be prevented by appropriate ICD reprogramming or avoidance of the initiating trigger.
Key Words: Ventricular oversensing, ICD, Complication
* Corresponding author. Tel: +49 351 4501700; fax: +49 351 4501702.E-mail address: post{at}thomas-rauwolf.de
Both authors contributed equally.
Manuscript submitted 29 May 2007. Accepted after revision 13 August 2007.
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