78 years old woman, implanted with a triple chamber defibrillator Viva XT CRT-D for ischemic cardiomyopathy with a large QRS ; routine follow-up and episode of T-wave oversensing
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Programming the new algorithm for the discrimination of the T wave oversensing can inhibit and prevent the occurrence of inappropriate therapies. This algorithm identifty alternation between two different cycles and signals (R-waves and T waves) of different amplitudes.
In this patient, the T wave oversensing is responsible for a decrease in the percentage of biventricular pacing. To avoid this oversensing, it is possible to change the programming of the right ventricular sensing polarity (bipolar to integrated bipolar). In this patient, this change did not had a positive effect. In contrast, reducing the ventricular sensitivity from 0.3 to 0.6 mV eliminated the oversensing. However, to certify the accurate detection of ventricular signals during an episode of arrhythmia, a FV induction test was performed with this new ventricular sensitivity.