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Related Experiment Videos

Unique sensing errors in third-generation implantable cardioverter-defibrillators

D J Callans1, B G Hook, R B Kleiman

  • 1Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, Philadelphia.

Journal of the American College of Cardiology
|October 1, 1993
PubMed
Summary
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Approximately 20% of patients with third-generation implantable cardioverter-defibrillators experience sensing errors. Prompt diagnosis and reprogramming effectively resolve these issues, improving device function.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Device Technology

Background:

  • Third-generation implantable cardioverter-defibrillators combine bradycardia and antitachycardia pacing with cardioversion-defibrillation.
  • The potential for unique sensing errors arising from combined algorithms has not been previously investigated.

Purpose of the Study:

  • To determine the incidence and types of sensing errors in combination therapy implantable cardioverter-defibrillators.
  • To assess the effectiveness of reprogramming in resolving these sensing errors.

Main Methods:

  • A 25-month study of 61 patients with combination therapy devices (Cadence and PCD).
  • Analysis included surface ECG, device testing, and review of real-time and stored electrograms and marker channels.
  • Sensing errors were diagnosed based on symptoms, device inefficacy, or inappropriate therapy delivery.

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Main Results:

  • 13 sensing errors were diagnosed in 12 patients (19.7% incidence), with similar rates between devices.
  • Five distinct categories of sensing errors were identified.
  • Following reprogramming, only one recurrent error occurred over 98 patient-months.

Conclusions:

  • Significant sensing errors affect approximately 20% of patients with third-generation combination therapy cardioverter-defibrillators.
  • Early identification of sensing errors allows for targeted reprogramming to prevent recurrence.