Key result
Programming an AV Interval Delta of 60 ms triggers recurrent inappropriate ICD shocks during sinus tachycardia.
Why the study?
Refinement in SVT discrimination algorithms can lead to inappropriate ICD shocks, but the impact of specific algorithm parameters on therapy appropriateness requires clarification.
Case Report (n=1)
No
May precipitate inappropriate ICD shocks in sinus tachycardia; leaves open optimal AV delta programming.
A 54-year-old male with ischemic cardiomyopathy and cardiac resynchronization therapy defibrillator implantation (St.Jude Medical, St. Paul, MN) 6 months prior to presentation and with a history of ventricular tachycardia (VT) storm suddenly received multiple implantable cardioverter-defibrillator (ICD) shocks.Device interrogation showed a normally functioning biventricular ICD.The initial supraventricular tachycardia appears to be a sinus tachycardia.A premature ventricular complex during tachycardia and the atrioventricular (AV) Interval Delta parameter value of 60 ms led to a diagnosis of VT resulting in inappropriate therapies.The AV Interval Delta is helpful for discrimination during dual tachycardia, but utilization of every discriminator algorithm in a particular patient should be adapted to the specific arrhythmic substrate of the patient.
No takes yet. Share an insight, caveat, or question.
John V. Wylie (2016) conducted a case report in Ischemic cardiomyopathy with CRT-D and history of VT storm (n=1). AV Interval Delta parameter programming was evaluated on Inappropriate ICD shocks. Programming the AV Interval Delta to 60 ms led to 14 inappropriate ICD shocks over 30 minutes when a premature ventricular complex occurred during sinus tachycardia.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: