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Shocking Truths about Implantable Cardioverter Defibrillator Monitoring Zones
Author(s) -
MANSOUR FADI,
THIBAULT BERNARD,
DUBUC MARC,
GUERRA PETER G.,
MACLE LAURENT,
BRUGADA RAMON,
ROY DENIS,
TALAJIC MARIO,
KHAIRY PAUL
Publication year - 2007
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.1540-8159.2007.00827.x
Subject(s) - medicine , implantable cardioverter defibrillator , cardiology , medical emergency , intensive care medicine
A 36 year‐old man with hypertrophic cardiomyopathy and an ATLAS + DR implantable cardioverter defibrillator (ICD) (St. Jude Medical, Inc., St. Paul, MN, USA) for primary prevention received a shock while cycling. The ventricular fibrillation detection threshold was 182 beats/min. An additional monitoring zone was programmed to 156 beats/min with all discriminators “on” except morphology. On interrogation, the ICD shock followed sinus tachycardia. In the absence of a monitoring zone, device therapy would not have been expected. We explore the mechanisms by which monitoring zones could potentially contribute to inappropriate ICD therapy and offer trouble‐shooting tips.