Open AccessClinical and electrocardiographic predictors of T wave oversensing in patients with subcutaneous ICD
Author(s) -
ElChami Mikhael F.,
Harbieh Bernard,
Levy Mathew,
Leon Angel R.,
Merchant Faisal M.
Publication year - 2016
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2016.01.002
Subject(s) - medicine , qrs complex , cardiology , ventricle
Background T wave oversensing (TWOS) is a major drawback of the subcutaneous implantable cardioverter defibrillator (S‐ICD). Data on predictors of TWOS in S‐ICD recipients are limited. We sought to investigate predictors of TWOS in a cohort of patients receiving an S‐ICD at our institution. Methods S‐ICD recipients at our center were identified retrospectively and stratified based on the presence or absence of TWOS. Clinical and electrocardiographic parameters were collected and compared between the 2 groups. Results Ninety‐two patients underwent an S‐ICD implantation at our institution between April 2010 and January 2015. Six (6.5%) patients had TWOS. These patients were younger (38.1±13.7 vs. 52.3±16.1 years, p =0.04) and had higher left ventricle ejection fractions (48.5±14.9% vs. 28.4±12.2%, p <0.01) than patients without a history of TWOS. Baseline 12‐lead electrocardiogram (ECG) parameters were not different between the 2 groups. Leads I, II, and avF (which mimic the sensing vectors of the S‐ICD) were further inspected to identify ECG characteristics that could predict TWOS. The QRS amplitude in ECG lead I was significantly smaller in the TWOS group than in the non‐TWOS group (3.7 vs. 7.4 mV, p =0.02). Conclusion In this study, younger age, higher ejection fraction, and lower QRS amplitude were associated with TWOS. These findings could help identify patients referred for S‐ICD at high‐risk of TWOS.