Avoiding ICD lead revision in a patient with chronically low R-wave amplitudes
█ Case report
Matthias Ernst1, László Sághy1, Stefan H. Hohnloser2, Máté Vámos1,2
1University of Szeged, 2nd Department of Medicine and Cardiology Center, Szeged, Hungary
2University Hospital Frankfurt – Goethe University, Dep. of Cardiology, Frankfurt am Main, Germany
A patient with non-ischemic cardiomyopathy and a 10-year-old primary prophylactic implantable cardioverter-defibrillator system (ICD) was admitted after experiencing two ICD-shocks. The interrogation of the device revealed chronically low R-wave amplitudes leading to intermittent T-wave oversensing and inappropriate shock delivery. During box exchange, we could avoid lead revision by intraoperative testing and subsequent reprogramming of the sensing vector from true to integrated bipolar configuration in the new generator. This programming feature is currently available only in certain ICD models.