Why the study?
Hypertrophic cardiomyopathy and Wolff-Parkinson-White syndrome carry a risk of sudden cardiac death, and T-wave oversensing is the most common cause of inappropriate S-ICD shocks.
In patients with an S-ICD and underlying conditions like HCM or prior ablation, electrical remodeling and disease progression can cause vector changes leading to T-wave oversensing and inappropriate shocks, which may be managed by exercise-optimized reprogramming.
Hypertrophic cardiomyopathy (HCM) and Wolff-Parkinson-White syndrome have been associated with sudden cardiac death. A subcutaneous implantable cardioverter-defibrillator (S-ICD) is an effective device used to reduce the risk of sudden cardiac death in these patients. The most common cause of inappropriate shocks with S-ICD is T-wave oversensing. We present the case of a 19-year-old man with repeated shocks from his S-ICD. This case highlights some of the sensing issues related to the S-ICD that can result in inappropriate shocks. A vector change may have occurred after T-wave remodeling, post accessory pathway ablation, and loss of R-waves due to HCM scar progression, leading to this consequence.
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Mohammadi et al. (2020) studied this question.
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