Journal Article

Unusual cause for an increase of the sensing integrity counter in a patient with inappropriate implantable cardioverter-defibrillator therapy

Dirk Vollmann, Lars Lüthje and Markus Zabel

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 9, issue 5, pages 275-277
Published in print May 2007 | ISSN: 1099-5129
Published online March 2007 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eum028
Unusual cause for an increase of the sensing integrity counter in a patient with inappropriate implantable cardioverter-defibrillator therapy

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We describe the case of a patient who presented with multiple implantable cardioverter-defibrillator (ICD) shock discharges 12 months after device implantation. Upon device interrogation, intermittent oversensing of electrical noise and potential ICD lead failure were suggested by a significant increase in the sensing integrity counter (SIC), a cumulative count of very short ventricular sensed intervals. Analysis of stored episodes, however, revealed that inappropriate ICD therapy had been caused by intermittent T-wave oversensing (TWO), and that the increase of the SIC resulted from the coincidence of TWO and premature ventricular complexes (PVCs). T-wave oversensing resolved and the SIC did not increase any more during follow-up after adjustment of ventricular sensitivity. The coincidence of TWO and PVCs should therefore be considered as an uncommon cause for short ventricular sensed intervals in ICD patients presenting with a suspect increase in the SIC.

Keywords: Implantable-cardioverter defibrillator; Oversensing; Inappropriate therapy; Sensing integrity counter

Journal Article.  1602 words.  Illustrated.

Subjects: Cardiovascular Medicine

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