May 1, 1992Pacing and Clinical Electrophysiology
Failure of a Second and Third Generation Implantable Cardioverter Defibrillator to Sense Ventricular Tachycardia: Implications for Fixed‐Gain Sensing Devices
Key result
Automatic-gain ICD restores VT sensing after fixed-gain device failure despite adequate R waves.
- n=1
Why the study?
Failure to sense ventricular tachycardia and/or ventricular fibrillation by ICDs using fixed-gain sensing is rare but clinically important to recognize and manage.
Population
A patient with second and third generation ICDs using fixed-gain sensing
Comparison
Second and third generation ICDs with fixed-gain sensing vs new device with automatic-gain sensing and epicardial leads
Design
Case report
Follow-up
Late after implantation, discovered at follow-up electrophysiology testing
Authors
Discussion
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Member takes
Implication
Alerts clinicians to rare fixed-gain ICD undersensing despite normal sinus sensing; leaves open optimal sensing algorithms for future devices.
Study Design
Type
Case Report (n=1)
Structured PICO
P
Population
A single case report of a patient experiencing persistent undersensing of ventricular tachycardia with second and third generation fixed-gain implantable cardioverter defibrillators.
I
Intervention
Placement of a new device with an automatic-gain sensing algorithm and use of previously implanted epicardial leads
C
Comparator
Second and third generation ICD using fixed-gain sensing
O
Outcome
Appropriate sensing of ventricular tachyarrhythmias
Fixed-gain sensing ICDs may fail to sense ventricular tachycardia late after implantation, highlighting the need for follow-up electrophysiology testing and potential replacement with automatic-gain sensing devices.
Cite This Study
Sperry et al. (1992) conducted a case report in Ventricular tachycardia and/or ventricular fibrillation (n=1). Fixed-gain sensing implantable cardioverter defibrillators vs. Automatic-gain sensing algorithm device was evaluated on Sensing of ventricular tachycardia. A second and third generation fixed-gain ICD failed to sense ventricular tachycardia despite adequate R wave sensing, requiring replacement with an automatic-gain sensing device.