Key result
An implantable cardioverter defibrillator failed to properly sense ventricular fibrillation due to large oscillatory changes in the local electrogram amplitude, preventing appropriate shock therapy.
Case Report (n=1)
Large oscillatory changes in local electrogram amplitude during ventricular fibrillation can cause ICD undersensing and failure to deliver life-saving shock therapy.
Raises caution for ICD undersensing in VF from electrogram amplitude oscillations; leaves open questions on optimal sensing algorithms.
A 48-year-old man was admitted after an episode of aborted sudden death with external defibrillation. An implantable cardioverter defibrillator implanted 2 years before for secondary prevention failed to sense properly an episode of ventricular fibrillation. Interrogation of the device showed large oscillatory changes of the amplitude of the local electrogram during ventricular fibrillation, causing undersensing and inappropriate refraining from shock therapy.
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Anguera et al. (2011) conducted a case report in Ventricular fibrillation (n=1). Implantable cardioverter defibrillator was evaluated on Undersensing of ventricular fibrillation. An implantable cardioverter defibrillator failed to properly sense ventricular fibrillation due to large oscillatory changes in the local electrogram amplitude, preventing appropriate shock therapy.
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