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Postoperative ergometry‐guided programming does not prevent T‐wave oversensing and inappropriate shocks in S‐ICD patients
Author(s) -
Larbig Robert,
Motloch Lukas J.,
Bettin Markus,
Fischer Alicia,
Frommeyer Gerrit,
Reinke Florian,
Loeher Andreas,
Eckardt Lars,
Köbe Julia
Publication year - 2018
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/pace.13327
Subject(s) - medicine , bicycle ergometer , incidence (geometry) , heart rate , blood pressure , physics , optics
Background T‐wave oversensing (TWOS) is a feared complication after subcutaneous implantable cardioverter‐defibrillator (S‐ICD) implantation, potentially leading to inappropriate shocks (IS) with tremendous impact on quality of life. Hypothesis Postoperative ergometry facilitates primary and secondary prevention of TWOS or other potential causes of IS and optimizes S‐ICD programming. Methods We analyze the impact of ergometry guided‐programming (EMGP) on primary and secondary prevention of TWOS/IS in S‐ICD patients, we screened 146 patients implanted in our center (2010–2016) for the incidence of TWOS/IS during postoperative ergometry. Furthermore, to evaluate the outcome in 123 eligible patients complete follow‐up (FU) of at least 6 months up to 2 years was retrospectively analyzed. Results (1) Primary prevention: TWOS could only be provoked postoperatively in 3.7% of patients (n = 3/82). FU analyses did not reveal significant differences compared to our control group (Ctrl: n = 6/61, 9.8% vs EMGP: n = 5/62, 8.1%; P = 0.731). Further subgroup analyses of patients with postoperative ergometry in the close postoperative period (< 7 days; n = 3/45, 6.7%; P = 0.563) did not yield any significant difference. (2) Secondary prevention: We found various causes of TWOS/IS. In patients who underwent reprogramming due to previous TWOS/IS events we observed a 66.7% (n = 6/9) reduction of TWOS/IS using EMGP. Conclusion TWOS/IS has various causes while not all cases are exercise‐associated. Postoperative ergometry does not seem to be useful for primary prevention. Further trials need to investigate the potential benefit of EMGP for secondary prevention of TWOS/IS.