Safety threshold of R-wave amplitudes in patients with implantable cardioverter defibrillator

Abstract

NCT01561144; results.

Novel ventricular tachyarrhythmia detection enhancement detects undertreated life-threatening arrhythmias

“…Moreover, post-mortem studies suggest that mortality in ICD implanted patients can be due to undertreated ventricular tachyarrhythmias 13,18,24,25 . It is well recognized that undersensing of ventricular signals (R-waves) during VF in ICDs is a known limitation of the therapy 7 . While occasional undersensed events do not typically delay detection and treatment, the likelihood of this occurrence may be higher when longer detection times and/or faster detection rates are programmed.…”

Left Ventricular Lead Implantation for Detection of Ventricular Arrhythmias in Patient With Implantable Cardioverter Defibrillator and Low R Wave in Right Ventricle

“…An adequate R wave amplitude during VF is crucial to avoid undersensing during arrhythmic episodes and proper function of ICD [7] . A recent study shows that during the follow-up period baseline R wave amplitudes <2.5 mV may lead to high risk of delayed detection of VF [8] . Our patient was at high risk of undersensing ventricular arrhythmias and consequently, failure to deliver appropriate therapy.…”

Trends in implantable cardioverter defibrillator and cardiac resynchronisation therapy lead parameters for patients with arrhythmogenic and dilated cardiomyopathies

“…Lillo-Castellano et al. found that with an R wave amplitude of ≤2.5 mV there was a significant risk of undersensing in VF [7]. Ruetz et al.…”

“…Implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy – defibrillators (CRT-Ds) are often implanted in patients with these diseases. Disease progression raises the possibility that sensing or pacing parameters in these devices may deteriorate, with potential implications for safe delivery of tachycardia therapies in conditions involving the right ventricle (RV) [7]. In ARVC, fibro-fatty change can develop progressively, though the interventricular septum and left ventricle (LV) are commonly spared [3].…”