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Related Experiment Videos

Decrease in amplitude of intracardiac ventricular electrogram and inappropriate therapy in patients with an

Hiroshi Watanabe1, Masaomi Chinushi, Daisuke Izumi

  • 1Division of Clinical Pharmacology, Vanderbilt University School of Medicine, TN 37232-0575, USA.

International Heart Journal
|July 11, 2006
PubMed
Summary

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Low R-wave amplitude in implantable cardioverter defibrillators (ICD) can lead to inappropriate shocks. Careful monitoring is crucial, especially for patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) or sarcoidosis, to prevent adverse events.

Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • Intracardiac electrograms are vital for tachyarrhythmia discrimination by implantable cardioverter defibrillators (ICDs).
  • Low R-wave amplitude can result in undersensing of ventricular tachyarrhythmia and inappropriate ICD discharges due to oversensing.

Purpose of the Study:

  • To investigate adverse events associated with R-wave amplitude in patients with transvenous ICD systems.
  • To identify cardiac conditions linked to decreased R-wave amplitude.

Main Methods:

  • Analysis of intracardiac ventricular electrograms from 115 patients over one year post-ICD implantation.
  • Regular ICD status checks every 3 months.

Main Results:

  • Decreased R-wave amplitude was prevalent in arrhythmogenic hypertrophy cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy (ARVC), and sarcoidosis.

Related Experiment Videos

  • Low R-waves (< 5.0 mV) were observed in 13 patients, with higher frequency in ARVC (38%) and sarcoidosis (33%).
  • Inappropriate ICD therapy, primarily due to T-wave oversensing, occurred in 7 patients with low R-waves, particularly in those with sarcoidosis.

    • Conclusions:

    • Progressive cardiac disorders can lead to decreased R-wave amplitude, causing inappropriate ICD discharges and potential arrhythmogenicity.
    • Achieving high R-wave amplitude during implantation and diligent follow-up are essential, especially for ARVC and sarcoidosis patients.