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Undersensing of VF in a Patient With Optimal R Wave Sensing During Sinus Rhythm
Author(s) -
DEKKER LUKAS R.C.,
SCHRAMA TIM A.M.,
STEINMETZ FRANS H.L.,
TUKKIE RAYMOND
Publication year - 2004
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.1540-8159.2004.00542.x
Subject(s) - medicine , sinus rhythm , amplitude , normal sinus rhythm , rhythm , cardiology , qrs complex , sinus (botany) , optics , botany , physics , biology , genus , atrial fibrillation
We describe a case of potentially fatal undersensing of VF by a third generation ICD with predetermined automatic gain control. In this patient, ventricular sensing was optimal, as R wave amplitudes during sinus rhythm were at least 16 mV. Cyclical, high amplitude signals during VF elevated the sensing floor to such an extent that complete undersensing of subsequent lower amplitude local electrograms occurred. This led to bradypacing and complete ICD therapy failure. Therefore, high R wave amplitudes during sinus rhythm do not warrant flawless sensing during VF. (PACE 2004; 27[Pt. I] 833–834)