Intradevice interaction in a dual chamber implantable cardioverter defibrillator preventing ventricular tachyarrhythmia detection

J Cardiovasc Electrophysiol. 2000 Nov;11(11):1285-8. doi: 10.1046/j.1540-8167.2000.01285.x.

Abstract

Failure to detect ventricular tachycardia and/or ventricular fibrillation by implantable cardioverter defibrillators (ICDs) is a rare but serious problem. We report a case of failure to detect an episode of induced ventricular tachycardia by a dual chamber ICD, due to abbreviation of ventricular detection window secondary to programmed pacing parameters and a rate-smoothing algorithm. In this patient, the intradevice interaction was corrected by programming rate-smoothing off. This report highlights the potentially lethal consequences of critical timing relationships among the pacing function, arrhythmia detection, and the characteristics of the arrhythmia when using a modern dual chamber ICD. Physicians responsible for patients with ICDs must be aware of such interactions.

Publication types

  • Case Reports

MeSH terms

  • Algorithms
  • Artifacts
  • Cardiac Pacing, Artificial / adverse effects*
  • Defibrillators, Implantable / adverse effects*
  • Equipment Failure
  • Female
  • Humans
  • Middle Aged
  • Software
  • Tachycardia, Ventricular / diagnosis*