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Updated: Apr 28, 2026

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Left and Right Ventricle Leads Switch as a Solution for TWave Oversensing - How a Good Idea Turned Out Bad
Bsn Alzand1, Tje Phlips2, R Willems3
1Department of Cardiology, Glorieux General Hospital, Ronse, Belgium ; Department of Cardiology, OLV General Hospital, Aalst, Belgium ; Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.
Abstract:
A 50-year-old male with a CRT defibrillator received inappropriate ICD shocks due to T-wave oversensing. Decreasing the sensitivity to avoid T wave oversensing was not an option due to a suboptimal R-wave sensing amplitude. We decided to re-plug the LV lead in the RV port and the RV lead in the LV port. This however led to intermittent phrenic nerve stimulation due to mandatory bipolar (tip-ring) or unipolar (tip-can) pacing on the LV-lead from the RV port. Re-intervention was necessary with the implantation of an additional pacing/sensing RV lead. A software programmable choice to switch sensing and tachycardia detection from RV to LV lead could be a valuable feature in future CRT devices.
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