PMID- 20184977
OWN - NLM
STAT- MEDLINE
DCOM- 20110613
LR  - 20161222
IS  - 1556-3871 (Electronic)
IS  - 1547-5271 (Linking)
VI  - 7
IP  - 5
DP  - 2010 May
TI  - Causes of ventricular oversensing in implantable cardioverter-defibrillators: 
      implications for diagnosis of lead fracture.
PG  - 626-33
LID - 10.1016/j.hrthm.2010.01.013 [doi]
AB  - BACKGROUND: Implantable cardioverter-defibrillator (ICD) ventricular oversensing 
      may result in inappropriate therapy, which may be triggered by lead/connection 
      issues that require surgical revision or physiologic oversensing that may be 
      resolved with reprogramming. The sensing integrity counter (SIC) is an 
      oversensing diagnostic that increments for very rapid ventricular intervals < or 
      =130 ms. OBJECTIVE: The purpose of this study was to determine the causes of a 
      high SIC and the ability of additional diagnostics to differentiate 
      lead/connection issues from other causes of oversensing for patients with normal 
      impedance. METHODS: Frequent SICs were identified in patients during routine 
      follow-up visits. To diagnose the cause of oversensing, patients wore a modified 
      24-hour digital Holter monitor that recorded ECG, ventricular electrogram, and 
      the ICD Marker Channel (Medtronic). Recordings were reviewed to determine the 
      causes of oversensing. Patients with confirmed oversensing and adequate data were 
      analyzed. The number of SICs per day and the presence of a nonsustained 
      tachycardia (NST) episode with ventricular mean cycle length <220 ms were 
      retrieved from stored ICD data. RESULTS: Forty-eight patients had a median of 13 
      SICs/day. Presumed lead/connection issues occurred in 23% of patients, whereas 
      physiologic oversensing occurred in 77% of patients. A rapid NST was recorded 
      more commonly in patients with lead/connection issues than in those without (9/11 
      vs 1/37; P < .0001). CONCLUSION: Oversensing resulting in frequent, very short 
      intervals typically are caused by either lead/connection issues or physiologic 
      signals. The additional finding of rapid NSTs usually indicates a lead/connection 
      issue, even in the absence of impedance abnormalities.
CI  - Copyright 2010 Heart Rhythm Society. Published by Elsevier Inc. All rights 
      reserved.
FAU - Gunderson, Bruce D
AU  - Gunderson BD
AD  - Medtronic, Inc., Minneapolis, Minnesota, USA.
FAU - Swerdlow, Charles D
AU  - Swerdlow CD
FAU - Wilcox, Jay M
AU  - Wilcox JM
FAU - Hayman, Jean E
AU  - Hayman JE
FAU - Ousdigian, Kevin T
AU  - Ousdigian KT
FAU - Ellenbogen, Kenneth A
AU  - Ellenbogen KA
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20100115
PL  - United States
TA  - Heart Rhythm
JT  - Heart rhythm
JID - 101200317
SB  - IM
MH  - Defibrillators, Implantable/*adverse effects
MH  - Electric Countershock/*adverse effects
MH  - Electrocardiography
MH  - Electrocardiography, Ambulatory
MH  - Electrodes, Implanted
MH  - Equipment Design
MH  - Equipment Failure
MH  - *Equipment Failure Analysis
MH  - Equipment Safety
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Statistics, Nonparametric
MH  - Tachycardia, Ventricular/diagnosis/*therapy
MH  - Telemetry
MH  - Ventricular Fibrillation/diagnosis/*prevention & control
MH  - Ventricular Premature Complexes
EDAT- 2010/02/27 06:00
MHDA- 2011/06/15 06:00
CRDT- 2010/02/27 06:00
PHST- 2009/10/28 00:00 [received]
PHST- 2010/01/01 00:00 [accepted]
PHST- 2010/02/27 06:00 [entrez]
PHST- 2010/02/27 06:00 [pubmed]
PHST- 2011/06/15 06:00 [medline]
AID - S1547-5271(10)00035-4 [pii]
AID - 10.1016/j.hrthm.2010.01.013 [doi]
PST - ppublish
SO  - Heart Rhythm. 2010 May;7(5):626-33. doi: 10.1016/j.hrthm.2010.01.013. Epub 2010 
      Jan 15.