Use of an exercise test to enhance sensing vector assessment and prevent inadequate subcutaneous implantable cardioverter-defibrillator discharges

Ewa Świerżyńska; Maciej Sterliński; Paweł Syska; Krzysztof Sadowski; Łukasz Szumowski

doi:10.1016/j.jelectrocard.2021.05.013

Use of an exercise test to enhance sensing vector assessment and prevent inadequate subcutaneous implantable cardioverter-defibrillator discharges

J Electrocardiol. 2021 Jul-Aug:67:73-76. doi: 10.1016/j.jelectrocard.2021.05.013. Epub 2021 May 27.

Authors

Ewa Świerżyńska¹, Maciej Sterliński², Paweł Syska³, Krzysztof Sadowski⁴, Łukasz Szumowski²

Affiliations

¹ 1(st) Department of Arrhythmia, National Institute of Cardiology, 42 Alpejska St., 04-628 Warsaw, Poland; 1(st) Department of Cardiology, Doctoral School, Medical University of Warsaw, 61 Żwirki i Wigury St., 02-091 Warsaw, Poland. Electronic address: [email protected].
² 1(st) Department of Arrhythmia, National Institute of Cardiology, 42 Alpejska St., 04-628 Warsaw, Poland.
³ 2(nd) Department of Arrhythmia, National Institute of Cardiology, 42 Alpejska St., 04-628 Warsaw, Poland.
⁴ Department of Coronary Artery Disease and Cardiac Rehabilitation, National Institute of Cardiology, 42 Alpejska St., 04-628 Warsaw, Poland.

PMID: 34090117
DOI: 10.1016/j.jelectrocard.2021.05.013

Abstract

Subcutaneous implantable cardioverter-defibrillators are a modern alternative to classic cardioverter-defibrillators. Prior to implantation of the device, qualification based on assessment of the heart's specific rhythm shape during a resting electrocardiogram examination must be performed. In the presented case, a patient with a subcutaneous implantable cardioverter-defibrillator experienced numerous discharges during exercise. An exercise test was performed, which revealed a bundle branch block that appeared during exercise. The wide QRS complex was double- or triple-counted by the device, resulting in an inaccurate heart rate estimation and multiple discharges. Optimising the sensing vectors during exercise solved this problem.

Keywords: Discharges; Exercise test; Subcutaneous cardioverter-defibrillator.

MeSH terms

Defibrillators, Implantable*
Electric Countershock
Electrocardiography
Exercise Test*
Humans