Key result
Prolonged QRS in a CRT-D patient triggers inappropriate sensing integrity counter increases mimicking lead failure.
Why the study?
Lead failures in ICD therapy cause inadequate shocks and impair quality of life; the SIC algorithm may enhance early detection but can be inappropriately increased by prolonged QRS duration.
Case Report (n=1)
Prolonged QRS duration can cause inappropriate increases in the sensing integrity counter, mimicking lead failure in CRT-D patients.
Prolonged QRS may mimic lead failure on CRT-D sensing counters; leaves open algorithm specificity and warrants larger validation.
Lead failures are one of the major complications of implantable cardioverter-defibrillator (ICD) therapy, often leading to a series of inadequate shocks and thus greatly impairing the quality of life in patients and causing potential proarrhythmias.1 The sensing integrity counter (SIC), which is an algorithm that detects the cumulative count of very short ventricular sensed intervals, may enhance the early detection of lead failures.2–4 Here we present a rare case in which a prolonged QRS duration caused an inappropriate SIC increase and mimicked a lead failure.
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Ozu et al. (2020) conducted a case report in Prolonged QRS duration in a patient with a cardiac resynchronization therapy-defibrillator (n=1). Prolonged QRS duration was evaluated on Inappropriate sensing integrity counter increase mimicking lead failure. A prolonged QRS duration in a patient with a cardiac resynchronization therapy-defibrillator caused an inappropriate sensing integrity counter increase, mimicking a lead failure.
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