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Updated: Jul 12, 2025

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
An inappropriately-appropriate ICD therapy: What is the mechanism and what interventions can be done?
Athanasios Saplaouras1, Panagiotis Mililis1, Ourania Kariki1
1Arrhythmia Unit Onassis Cardiac Surgery Center Athens Greece.
Key Clinical Message:
R-wave double counting is a rare cause of ventricular oversensing that can lead to inappropriate shocks. Optimizing device programming is essential for the avoidance of subsequent inappropriate therapies.
Abstract:
R-wave double counting is a rare cause of ventricular oversensing that can lead to inappropriate shocks. We present the case of a female patient, 52-years-old with a history of end-stage hypertrophic cardiomyopathy. The patient suffered an implantable cardioverter-defibrillator (ICD) shock. Cardiac device interrogation revealed ventricular tachycardia (VT) with a cycle length of 420 ms that was misclassified in the ventricular fibrillation (VF) zone owing to R-wave double counting. Optimizing device programming is essential for the avoidance of subsequent inappropriate therapies. Possible therapeutic options are briefly presented in the case.
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