Biventricular pacing ICDs can lead to inappropriate shocks due to double detection of ventricular premature beats, highlighting an inherent detection problem of dual ventricular sensing.
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Alerts clinicians to double-sensing risk in BiV ICDs; leaves open whether algorithms need redesign.
SCHREIECK, J., et al. : Inappropriate Shock Delivery Due to Ventricular Double Detection with a Biventricular Pacing Implantable Cardioverter Defibrillator. This report describes a patient with advanced heart failure, pronounced intraventricular conduction delay, and ventricular tachycardias who underwent implantation of a multisite pacing ICD. Pacing leads were placed in the right atrium, right ventricular apex, and to the left ventricular posterior wall via a coronary sinus vein. The system proved to have correct sensing and pacing function in an atrial synchronized biventricular pacing mode and an appropriate detection of ventricular fibrillation. However, 1 month after implantation the patient received an inappropriate shock delivery due to double detection of ventricular premature beats. The inherent detection problem of dual ventricular sensing is discussed.
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Schreieck et al. (2001) studied this question.
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