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Updated: Jun 19, 2026

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
A rare type of ventricular oversensing in ICD therapy--inappropriate ICD shock delivery due to triple counting
Michael Guenther1, Thomas P Rauwolf, Manja Bock
1Medical Clinic, Department of Internal Medicine and Cardiology, University of Technology-Dresden, Fetscherstrasse 76,Dresden, Germany. michael.guenther2@mailbox.tu-dresden.de
Abstract:
Irregular sensing by triple counting of wide QRS complexes resulted in inappropriate shocks in a patient with a biventricular implantable cardioverter defibrillator (ICD): A 66-year-old male patient with ischemic cardiomyopathy, left bundle branch block, and impaired left ventricular function received a biventricular ICD for optimal therapy of heart failure (CHF). Two years after implantation, the patient experienced recurrent unexpected ICD shocks without clinical symptoms of malignant tachyarrhythmia, or worsened CHF. The patient's condition rapidly worsened, with progressive cardiogenic shock and electrical-mechanical dissociation. After unsuccessful resuscitation of the patient the interrogation of the ICD showed an initial triple counting of extremely wide and fragmented QRS complexes with inappropriate shocks.
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