What does this research mean for the field?

Falsely detected atrial tachycardia in a CRT-P patient led to inappropriate BiV pacing triggered by oversensing phenomena. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research investigates the impact of falsely detected atrial tachycardia episodes on ventricular pacing in CRT-P patients.

January 10, 2026Journal of Arrhythmia0 citationsOpen Access

Atrial Tram Tracks and Ventricular Step Ladder: Decoding the Dot Plot

RVRamanathan VelayuthamJawaharlal Institute of Post Graduate Medical Education and Research ABAnish M. BhargavJawaharlal Institute of Post Graduate Medical Education and Research BJBarathkrishnan JanarthananJawaharlal Institute of Post Graduate Medical Education and Research

Key Result

Falsely detected atrial tachycardia in a CRT-P patient led to inappropriate BiV pacing triggered by oversensing phenomena.

Key Points

This research investigates the impact of falsely detected atrial tachycardia episodes on ventricular pacing in CRT-P patients.
Analyzed atrial tachycardia detection mechanisms
Examined outcomes of BiV pacing triggered by vents
Investigated FFRW oversensing and its effects
Falsely detected atrial tachycardia episodes were common
BiV pacing was automatically triggered in response
Auto adjusting sensitivity complicated detection

Structured PICO

Population

1 65-year-old male with non-ischemic cardiomyopathy, left bundle branch block, severe left ventricular systolic dysfunction, and a biventricular CRT-P device implanted 8 years ago.

Intervention

Device interrogation and dot plot analysis

Dot plot analysis in CRT devices can decode complex tram track and step ladder patterns caused by far-field R wave oversensing and auto-adjusting sensitivity phenomena.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Falsely detected atrial tachycardia episode in a patient with CRT‐P due to FFRW oversensing resulting in ventricular sensed response triggered BiV pacing and auto adjusting sensitivity phenomenon.

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