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Postoperative ergometry-guided programming does not prevent T-wave oversensing and inappropriate shocks in S-ICD
Robert Larbig1, Lukas J Motloch2, Markus Bettin1
1Division of Electrophysiology, Department of Cardiovascular Medicine, University of Muenster, Muenster, Germany.
Pacing and Clinical Electrophysiology : PACE
|March 25, 2018
Summary
Postoperative ergometry did not prevent T-wave oversensing (TWOS) after subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation. However, ergometry-guided programming significantly reduced TWOS/inappropriate shocks in patients with prior events.
Area of Science:
- Cardiology
- Medical Devices
- Electrophysiology
Background:
- T-wave oversensing (TWOS) is a significant complication of subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation.
- TWOS can lead to inappropriate shocks (IS), severely impacting patient quality of life.
Purpose of the Study:
- To evaluate the effectiveness of ergometry-guided programming (EMGP) in preventing TWOS/IS.
- To assess EMGP for both primary and secondary prevention of TWOS/IS in S-ICD patients.
Main Methods:
- Retrospective analysis of 146 S-ICD patients implanted between 2010-2016.
- Screening for TWOS/IS during postoperative ergometry and analyzing follow-up data for 123 eligible patients.
Main Results:
- TWOS was provoked postoperatively in only 3.7% of patients for primary prevention, with no significant difference compared to controls.
- EMGP showed a 66.7% reduction in TWOS/IS events for secondary prevention in patients who underwent reprogramming.
Conclusions:
- Postoperative ergometry is not effective for the primary prevention of TWOS/IS in S-ICD patients.
- EMGP may offer benefits for the secondary prevention of TWOS/IS, warranting further investigation.
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