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Dual Device Therapy in the Setting of Changing ICD Technology: Device‐Device Interaction Revisited
Author(s) -
SHEAHAN RICHARD G.,
DORIAN PAUL,
POLUDNIKIEWICZ MARY,
NEWMAN DAVID
Publication year - 1997
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1997.tb03543.x
Subject(s) - medicine , qrs complex , dual (grammatical number) , implant , cardiology , surgery , art , literature
This case report concerns an adverse device‐device interaction between a replacement ICD and a dual chamber rate responsive pacemaker. It was observed that subtle changes in the design of sensing circuits between an older first‐generation ICD and the newer third‐generation ICD device led to unexpected and dramatic changes in the interactive behavior of a dual device system. The new ICD was connected to chronically implanted hardware. The sensing behavior of the newer ICD included a shorter time constant in the decay of the automatic gain control function, resulting in triple sensing of both the atrial and ventricular paced stimuli and the evoked QRS complex. Physicians should be aware of new design changes in the future so as to anticipate such interactions. In the setting of rapidly changing technology, extra caution must be exercised when choosing to implant two devices in the same patient.