Integrated bipolar lead systems in dual chamber ICDs were associated with significantly more frequent ventricular oversensing compared to dedicated bipolar leads (40.4% vs 8.2%, P=0.0002).
Cohort (n=101)
Does the use of integrated bipolar lead systems compared to dedicated bipolar lead systems increase ventricular oversensing in patients with dual chamber ICDs?
Integrated bipolar leads are significantly more susceptible to ventricular oversensing, particularly T wave and P wave oversensing, compared to dedicated bipolar leads in patients with dual chamber ICDs.
Absolute Event Rate: 40.4% vs 8.2%
p-value: p=0.0002
UNLABELLED: Modern dual chamber ICD systems are able to overcome various sensing problems. However, improvement of their performance is still required. The aim of this study was to assess the sensing function in 101 consecutive patients (84 men, 17 women; mean age 63 +/- 12 years; mean follow-up 24 +/- 4 months) implanted with dual chamber defibrillators and integrated (IB) or dedicated bipolar (DB) lead systems. Follow-up data were analyzed for the presence of ventricular oversensing. Oversensing occurred in 25 (25%) patients, significantly more frequent in patients implanted with IB compared to DB lead systems (21/52 vs 4/49, P = 0.0002). Patients with cardiomyopathies (CMs) were more prone to sensing malfunctions than patients with no CM (12/30 vs 13/71, P = 0.04). T wave oversensing (n = 14), respirophasic ventricular oversensing (n = 4), and P wave oversensing (n = 6) were the most common pitfalls of ventricular sensing. P wave oversensing was unique to the IB lead system. CT scans performed in these patients disclosed the position of the RV coil to be proximal to the tricuspid area. Four patients received inappropriate ICD shocks due to oversensing. In all but two patients who received lead revision, oversensing was resolved by noninvasive means. IN CONCLUSION: (1) ventricular oversensing is a common problem occurring in up to 25% of patients with dual chamber ICDs; (2) P wave oversensing is a ventricular sensing problem affecting function of 11% of dual chamber devices with IB lead systems; (3) IB leads are significantly more susceptible to T wave and P wave oversensing than DB leads; and (4) patients with cardiomyopathies are more prone to oversensing than patients with other heart diseases.
Weretka et al. (Wed,) conducted a cohort in Patients implanted with dual chamber defibrillators (n=101). Integrated bipolar (IB) lead systems vs. Dedicated bipolar (DB) lead systems was evaluated on Presence of ventricular oversensing (p=0.0002). Integrated bipolar lead systems in dual chamber ICDs were associated with significantly more frequent ventricular oversensing compared to dedicated bipolar leads (40.4% vs 8.2%, P=0.0002).