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Europace 2008 10(5):552-555; doi:10.1093/europace/eun083
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

ICDs

T-wave oversensing and inappropriate shocks: a case report

Komandoor Srivathsan, Luis R. Scott and Gregory T. Altemose*

Mayo Clinic Arizona—Mayo Clinic Hospital, Cardiovascular Diseases, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA

A 27-year-old male with congenital long QT syndrome, SCN5A mutation experienced recurrent inappropriate exercise-related implantable cardioverter defibrillator (ICD) shocks. This device showed T-wave oversensing with double, which lead to these device discharges. Dynamic T-wave oversensing was reproducibly provoked at exercise treadmill testing and was confirmed as the mechanism leading to double counting. The insertion of a new pacing and sensing lead with increased R-wave amplitude did not solve the problem. Exchanging the existing ICD generator with one capable of automatic sensitivity control (Biotronik, Lexos DR, Biotronik, Berlin, Germany) completely eliminated T-wave oversensing and inappropriate shocks.

Key Words: Long QT syndrome, T-wave oversensing, Inappropriate shocks

* Corresponding author. Tel: +1 480 342 0239; fax: +1 480 342 1606. E-mail address: altemose.gregory{at}mayo.edu

Manuscript submitted 21 January 2008. Accepted after revision 18 March 2008.


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