Diagnosis of slow ventricular tachycardia by cardiac resynchronization devices utilizing a desynchronization...

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Device Technology

Background:

• Cardiac resynchronization therapy (CRT) devices with left ventricular (LV) sensing can exhibit specific desynchronization rhythms.
• BIOTRONIK devices feature a "CRT pacing interrupt" algorithm designed to record these desynchronization events.

Purpose of the Study:

• To investigate the utility of the "CRT pacing interrupt" function in diagnosing slow ventricular tachycardia (VT).
• To report cases where this function unexpectedly aided in slow VT detection.

Main Methods:

• Analysis of recordings from six patients where the "CRT pacing interrupt" function was activated.
• Evaluation of device interpretations of desynchronization arrhythmias versus actual slow VT episodes.

Main Results:

• The "CRT pacing interrupt" function facilitated the diagnosis of slow VT in six patients.
• Device misinterpretation of slow VT as desynchronization led to recordings consistent with slow VT.
• Diagnosis was achieved regardless of the relationship between LV upper rate interval and slow VT cycle length.

Conclusions:

• The "CRT pacing interrupt" algorithm, though not designed for it, can aid in diagnosing slow VT.
• Device-recorded "desynchronization" may indicate underlying slow VT, prompting further investigation.
• This highlights an unexpected diagnostic capability of CRT pacing interrupt algorithms.