T-wave oversensing by an implantable cardioverter defibrillator after successful ablation of idiopathic ventricular fibrillation

Pacing Clin Electrophysiol. 2006 Apr;29(4):431-5. doi: 10.1111/j.1540-8159.2006.00367.x.

Abstract

Focal ablation of trigger premature ventricular complexes (PVCs) from the Purkinje system helped to suppress idiopathic ventricular fibrillation (VF) in an athlete who had suffered from frequent appropriate shock therapies. However, only a few days after successful ablation T-wave oversensing occurred during exercise and resulted in repetitive distressing defibrillator shocks. Despite lack of any changes on the surface ECG, the endocardially recorded electrogram revealed an unfavorable ratio of R-to-T-wave amplitude predisposing to double counting with accelerated heart rates. This case illustrates that T-wave oversensing may complicate the clinical course after successful ablation of malignant Purkinje ectopy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Catheter Ablation*
  • Defibrillators, Implantable / adverse effects*
  • Diagnostic Errors*
  • Electrocardiography / adverse effects*
  • Electrocardiography / methods*
  • Equipment Failure
  • Humans
  • Male
  • Ventricular Fibrillation / diagnosis*
  • Ventricular Fibrillation / etiology*
  • Ventricular Fibrillation / prevention & control