A rare type of ventricular oversensing in ICD therapy--inappropriate ICD shock delivery due to triple counting

Pacing Clin Electrophysiol. 2010 Feb;33(2):e17-9. doi: 10.1111/j.1540-8159.2009.02583.x. Epub 2009 Oct 10.

Abstract

Irregular sensing by triple counting of wide QRS complexes resulted in inappropriate shocks in a patient with a biventricular implantable cardioverter defibrillator (ICD): A 66-year-old male patient with ischemic cardiomyopathy, left bundle branch block, and impaired left ventricular function received a biventricular ICD for optimal therapy of heart failure (CHF). Two years after implantation, the patient experienced recurrent unexpected ICD shocks without clinical symptoms of malignant tachyarrhythmia, or worsened CHF. The patient's condition rapidly worsened, with progressive cardiogenic shock and electrical-mechanical dissociation. After unsuccessful resuscitation of the patient the interrogation of the ICD showed an initial triple counting of extremely wide and fragmented QRS complexes with inappropriate shocks.

Publication types

  • Case Reports

MeSH terms

  • Bundle-Branch Block / physiopathology
  • Cardiomyopathies / physiopathology
  • Defibrillators, Implantable*
  • Fatal Outcome
  • Female
  • Heart Failure / therapy*
  • Humans
  • Male
  • Prosthesis Failure*
  • Tachycardia / etiology*
  • Ventricular Function, Left