scholarly journals INAPPROPRIATE S-ICD PATIENT RECEIVES FALSE POSITIVE SHOCKS

2020 ◽  
Vol 50 (2) ◽  
pp. 69-72
Author(s):  
David Korpas

Subcutaneous implantable cardioverter defibrillator (S-ICD) protects the patients at risk for sudden cardiac death while leaving the heart and vasculature untouched. It provides life-saving therapy, but may also deliver inappropriate therapy. Presented case demonstrates a possibility of S-ICD therapy induction due to double-counting. It was original caused by lack of suitable sensing vectors and the solution was possible just particularly. As the inter-individual variability of subcutaneous cardiac signal is considerable, the patient screening should be necessary for identification of such patients, which have an unsuitable subcutaneous sensing signals.

2017 ◽  
Vol 6 (1) ◽  
pp. 19
Author(s):  
Charles D Swerdlow ◽  

Mark Josephson dedicated his career to the prevention of premature sudden cardiac death (SCD). Toward that goal, he was an early adopter of the implantable cardioverter defibrillator (ICD) and indefatigable advocate for better ICD technology,1 both as a clinical tool and as living laboratory to study SCD in ambulatory patients. With characteristic intellectual integrity and analytical rigour, he sought an honest and balanced appraisal of the life-saving benefits and serious complications of this unique therapy.


EP Europace ◽  
2018 ◽  
Vol 20 (FI2) ◽  
pp. f225-f232 ◽  
Author(s):  
Valentina Kutyifa ◽  
Katherine Vermilye ◽  
Usama A Daimee ◽  
Scott McNitt ◽  
Helmut Klein ◽  
...  

2012 ◽  
Vol 5 (3) ◽  
pp. e166-e170 ◽  
Author(s):  
Fabio Marsico ◽  
Gianluigi Savarese ◽  
Celestino Sardu ◽  
Cristoforo D’Ascia ◽  
Donatella Ruggiero ◽  
...  

Author(s):  

Dilated cardiomyopathy (DCM) is a disease characterised as left ventricular (LV) or biventricular dilatation with impaired systolic function. Regardless of underlying cause patients with DCM have a propensity to ventricular arrhythmias and sudden cardiac death. Implantable Cardioverter Defibrillator (ICD) implantation for these patients results in significant reduction of sudden cardiac death [1-3]. ICD devices may be limited by right ventricle (RV) sensing dysfunction with low RV sensing amplitude. We present a clinical case of patient with DCM, implanted ICD and low R wave sensing on RV lead.


Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Tuomas Kenttä ◽  
Bruce D Nearing ◽  
Kimmo Porthan ◽  
Jani T Tikkanen ◽  
Matti Viitasalo ◽  
...  

Introduction: Noninvasive identification of patients at risk for sudden cardiac death (SCD) remains a major clinical challenge. Abnormal ventricular repolarization is associated with increased risk of lethal ventricular arrhythmias and SCD. Hypothesis: We investigated the hypothesis that spatial repolarization heterogeneity can identify patients at risk for SCD in general population. Methods: Spatial R-, J- and T-wave heterogeneities (RWH, JWH and TWH, respectively) were automatically analyzed with second central moment technique from standard digital 12-lead ECGs in 5618 adults (46% men; age 50.9±12.5 yrs.) who took part in Health 2000 Study, an epidemiological survey representative of the entire Finnish adult population. During average follow-up of 7.7±1.4 years, a total of 72 SCDs occurred. Thresholds of RWH, JWH and TWH were based on optimal cutoff points from ROC curves. Results: Increased RWH, JWH and TWH (Fig.1) in left precordial leads (V4-V6) were univariately associated with SCD (P<0.001, each). When adjusted with clinical risk markers (age, gender, BMI, systolic blood pressure, cholesterol, heart rate, left ventricular hypertrophy, QRS duration, arterial hypertension, diabetes, coronary heart disease and previous myocardial infarction) JWH and TWH remained as independent predictors of SCD. Increased TWH (≥102μV) was associated with a 1.9-fold adjusted relative risk (95% confidence interval [CI]: 1.2 - 3.1; P=0.011) and increased JWH (≥123μV) with a 2.0-fold adjusted relative risk for SCD (95% CI: 1.2 - 3.3; P=0.004). When both TWH and JWH were above threshold, the adjusted relative risk for SCD was 3.2-fold (95% CI: 1.7 - 6.2; P<0.001). When all heterogeneity measures (RWH, JWH and TWH) were above threshold, the risk for SCD was 3.7-fold (95% CI: 1.6 - 8.6; P=0.003). Conclusions: Automated measurement of spatial J- and T-wave heterogeneity enables analysis of high patient volumes and is able to stratify SCD risk in general population.


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