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A Pitfall in Using Far‐Field Bipolar Electrograms in Arrhythmia Discrimination in a Patient with an Implantable Cardioverter Defibrillator
Author(s) -
NAYAK HEMAL M.,
TSAO LANA,
SANTONIRUGIU FRANCESCO,
GOMES J. ANTHONY,
MEHTA DAVENDRA
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.tb05447.x
Subject(s) - medicine , ventricular tachycardia , cardiology , sinus rhythm , implantable cardioverter defibrillator , paroxysmal supraventricular tachycardia , tachycardia , atrial fibrillation
Analysis of stored electrograms from bipolar far‐field electrodes is considered to be useful in differentiating supraventricular from ventricuiar arrhythmias. A case of inappropriate ICD shocks for sinus tachycardia is presented whereby successive shocks caused marked widening of the ventricuiar electrograms. Analysis of these stored electrograms, recorded from far‐field bipolar electrodes, gave the false impression of ventricuiar tachycardia. The widening was due to the current of injury effects, probably a consequence of the large amount of intervening myocardium between the bipoies. While analyzing recordings from far‐field bipolar electrodes is generally useful, it is not always reliable, for changes in electrogram morphoiogy, reiative to baseline rhythm, may result from other factors like current of injury.