New device, dual R-wave counting and SecureSense™ algorithm
Patient
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Man implanted with an Abbott Gallant CRT defibrillator; episodes of unsustained V oversensing recorded in memory; SecureSense™ algorithm ON (VD coil to housing)
Trace
- Slow VT (atrioventricular dissociation with V>A)
- double counting of the R wave on the bipolar channel but not on the discrimination channel
- The noise counter is at 10; diagnosis of unsupported V oversensing (SNS)
Comments
episode of non-sustained ventricular oversensing
Points to remember
- This patient had episodes of slow VT with very wide QRS complexes, explaining the double counting of the R wave at the end of the ventricular refractory period.
- This type of oversensing can lead to aggressive therapies (repeated electrical shocks
- ) following a false diagnosis of VF (slow VT at 120 bpm with double counting and tachycardia detected at 240 bpm in the VF zone).
- The SecureSense™ algorithm enables early diagnosis even when oversensing is intermittent and would inhibit therapies in cases where a tachycardia counter is completed
- compteur de tachycardie serait complété
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