Shocking truths about implantable cardioverter defibrillator monitoring zones

Pacing Clin Electrophysiol. 2007 Sep;30(9):1146-8. doi: 10.1111/j.1540-8159.2007.00827.x.

Abstract

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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cardiomyopathy, Hypertrophic / prevention & control*
  • Defibrillators, Implantable / adverse effects*
  • Electric Countershock / adverse effects*
  • Equipment Failure
  • Equipment Failure Analysis
  • Humans
  • Male
  • Tachycardia, Ventricular / etiology*
  • Tachycardia, Ventricular / prevention & control*