CASE REPORTS
JOURNAL ARTICLE
Add like
Add dislike
Add to saved papers

Inappropriate defibrillator shocks from depolarization--repolarization mismatch in a patient with hypertrophy cardiomyopathy.

Despite wide use of dedicated bipolar sensing electrodes in implantable cardioverter-defibrillator (ICD) systems, oversensing occasionally occurs, leading to unwarranted shocks or antitachycardia pacing. This case report highlights an individual with hypertrophic cardiomyopathy (HCM) who experienced inappropriate shocks from oversensing of repolarization electrograms (T-waves). During the implantation procedure, no excessive T-wave amplitudes were detected during sinus rhythm, ventricular pacing, or induced ventricular fibrillation. T-wave oversensing leading to shocks only developed after maturation of the lead-tissue interface. An adequate safety margin for discrimination between ventricular electrograms and T-waves could not be assured. Thus, insertion of a new dedicated pacing-sensing electrode was required. The degree to which intracardiac repolarization signals may be heightened in patients with HCM has not been investigated systematically. However, a relative decrease in the ventricular electrogram amplitude without a concomitant decline of the intracardiac T-wave amplitude appears to have led to the problem in this patient. Special caution in technique and device selection with a particular emphasis on T-wave sensing may be prudent when ICDs are implanted in individuals with HCM. Additional programmable variables may also be beneficial in such cases.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app