Beta-blocker therapy can resolve inappropriate tachycardia detection caused by double counting in biventricular ICDs by lengthening AV conduction.
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May warrant trial in select biventricular ICD patients with double counting; hypothesis-generating and should not yet change practice.
GARCIA‐MORAN, E., et al. : Inappropriate Tachycardia Detection by a Biventricular Implantable Cardioverter Defibrillator. This case describes “double counting” of intrinsic conduction due to the combination of intraventricular conduction delay and the merging of the electrograms from the right and left ventricle (coronary sinus) leads in a biventricular cardioverter defibrillator. This situation prompted asymptomatic antitachycardia pacing. Lengthening of AV conduction by betablocker solved the problem.
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García‐Morán et al. (2002) studied this question.
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