Changing place, changing future: Repositioning a subcutaneous implantable cardioverter-defibrillator can resolve inappropriate shocks secondary to myopotential.

Slides:

Advertisements

Similar presentations

Implantation of the subcutaneous implantable cardioverter-defibrillator with retroperitoneal generator placement in a child with hypoplastic left heart.

Advertisements

Subcutaneous implantable cardioverter-defibrillator placement in a patient with a preexisting transvenous implantable cardioverter-defibrillator Mohammad-Ali.

Inhibition of pacing in a dependent patient with an implantable cardioverter-defibrillator and a left ventricular assist device Michele Murphy, MD, Timothy.

Volume 10, Issue 1, Pages (January 2013)

A new approach for implantation of a cardiac resynchronization therapy–defibrillator in a patient with bilateral pectoral neurostimulation devices Saori.

Inhibition of pacing in a dependent patient with an implantable cardioverter-defibrillator and a left ventricular assist device Michele Murphy, MD, Timothy.

Erroneous shock by an AED: Importance of obtaining AED tracing to prevent inappropriate ICD implantation Brian J. Cross, MD, Mark S. Link, MD, FHRS

Federico Migliore et al. JACEP 2016;2:

Swimming pool saline chlorination units and implantable cardiac devices: A source for potentially fatal electromagnetic interference John Wight, BS,

Inappropriate shock from delayed T-wave oversensing by a subcutaneous implantable cardioverter-defibrillator after septal myectomy for hypertrophic cardiomyopathy

Recurrent commotio cordis: Déjà vu

A case of paroxysmal atrioventricular block–induced cardiac arrest

Combination of a leadless pacemaker and subcutaneous defibrillator: First in-human report Blandine Mondésert, MD, Marc Dubuc, MD, FHRS, Paul Khairy,

Challenges in the diagnosis and management of idiopathic ventricular fibrillation Jonathan Lipton, MD, PhD, George J. Klein, MD, Raymond W. Sy, MBBS,

Ben Ng, MBBS, Robert W. Giles, MBBS, Zal Dastur, BSc, Mark A

Successful management of wound dehiscence after implantation of a subcutaneous implantable cardioverter-defibrillator without device removal Mitsuhiro.

Breast tissue expanders and implantable cardioverter-defibrillator: An unusual interaction Malik Muhammad Khurram Sher Khan, MD, Malik Muhammad Humayun.

Unusual case of late dislodgment of a superior vena cava coil

Is it bradycardia or something else causing symptoms?

T-wave oversensing during drug challenge test after subcutaneous implantable cardioverter-defibrillator implantation in a patient with Brugada syndrome

Inappropriate defibrillator shock during gynecologic electrosurgery

Anne Barnett, PA-C, Lee Eckhardt, MD, FHRS, Miguel A. Leal, MD, FHRS

Respiratory rate trending as a cause for atrial lead noise: A first report in an implantable cardioverter-defibrillator patient Isla McClelland, MD,

Pitfalls of pacemaker detection of ventricular high-rate events

Recurrent idiopathic polymorphic ventricular tachycardia/ventricular fibrillation successfully treated by cardiac sympathetic denervation Faisal Matto,

Repeated molecular genetic analysis in Brugada syndrome revealed a novel disease- associated large deletion in the SCN5A gene Anders Krogh Broendberg,

A rare case of acute myocardial infarction during extraction of a septally placed implantable cardioverter-defibrillator lead Eric Wierda, MD, LLM, Astrid.

T-wave oversensing from postural changes: A rare cause of inappropriate shock from a subcutaneous defibrillator Muhammad R. Afzal, MD, Auroa Badin, MD,

‘Runaway’ vagal nerve stimulator: a case of cyclic asystole

Failure of ICD therapy in lethal arrhythmogenic right ventricular cardiomyopathy type 5 caused by the TMEM43 p.Ser358Leu mutation Kasper Aalbæk Kjærgaard,

Substernal implantation of a subcutaneous implantable cardioverter-defibrillator in a patient with preexisting Hemodialysis Reliable Outflow graft Thomas.

Oral quinine sulfate for the treatment of electrical storm and prevention of recurrent shocks in Brugada syndrome after failed cilostazol therapy Jayaprakash.

Cardiac contractility modulation therapy: Are there superresponders?

Repeat inappropriate defibrillator discharges following defibrillator implantation. What is the mechanism and treatment? Jeremy W. Docekal, MD, Mark.

Complete congenital heart block: A case of multilevel block

Imre Hunyor, MBBS, DPhil, Hany S. Abed, MBBS, PhD, Raymond W

Subcutaneous implantable cardioverter-defibrillator placement in a patient with a preexisting transvenous implantable cardioverter-defibrillator Mohammad-Ali.

Right-sided subcutaneous implantable cardioverter-defibrillator placement in a patient with dextrocardia, tetralogy of Fallot, and conduction disease

Managing cross talk between a subcutaneous implantable cardioverter-defibrillator and a dual-chamber unipolar pacemaker system Konstantinos Kossidas,

Inappropriate shocks in a patient with a subcutaneous implantable cardioverter- defibrillator Sana M. Al-Khatib, MD, MHS, FHRS, Sasmrita Belbase, NP,

Albert N. Nayeri, MD, Behzad B. Pavri, MD HeartRhythm Case Reports

Appropriate use of genetics in a young patient with atrioventricular block and family history of sudden cardiac death Johnni Rudbeck-Resdal, MD, Jens.

Air entrapment causing early inappropriate shocks in a patient with a subcutaneous cardioverter-defibrillator Sing-Chien Yap, MD, PhD, Rohit E. Bhagwandien,

Oversensing of an unexpected atrial flutter

Inappropriate subcutaneous implantable cardioverter-defibrillator therapy due to R-wave amplitude variation: Another challenge in device management Syeda.

Daniel W. Nelson, BS, Caroline Vloka, BA, Jule Wetherbee, MD

Progressive electrical remodeling in apical hypertrophic cardiomyopathy leading to implantable cardioverter-defibrillator sensing failure during ventricular.

Haseeb Jafri, MD, Alan Cheng, MD, FHRS HeartRhythm Case Reports

Undetected ventricular fibrillation in a single-chamber implantable cardioverter- defibrillator: When the far-field channel sees more than the intraventricular.

Successful implantation of a subcutaneous cardiac defibrillator in a patient with a preexisting deep brain stimulator Yousef Bader, MD, Jonathan Weinstock,

Elizabeth V. Saarel, MD, FHRS, Susan P. Etheridge, MD, FHRS, David G

Subcutaneous implantable cardioverter-defibrillator implantation in a patient with bilateral pectoral deep brain stimulators Thor Tejada, MD, Faisal.

Different rate-dependent responses between J waves and the notches on an epicardial local electrogram in a patient with idiopathic ventricular fibrillation

Impact of a novel algorithm designed to reduce T-wave oversensing with the subcutaneous defibrillator in a patient with type I Brugada electrocardiogram

Abdominal implantable cardioverter-defibrillator placement in a patient requiring bilateral chest radiation therapy Ankur A. Karnik, MD, FHRS, CCDS,

Serious case of the hiccups

The runaway defibrillator…A case of an implantable cardioverter-defibrillator that failed communication and deactivation with a magnet Mahmoud Assaad,

Intermittent failure to capture: What is the mechanism?

Nothing inside the heart – Combining epicardial pacing with the S-ICD

Shock-induced right ventricular pacing failure caused by a short circuit: Uncommon but life-threatening complication of the Riata lead Itsuro Morishima,

Implantation of the subcutaneous implantable cardioverter-defibrillator with retroperitoneal generator placement in a child with hypoplastic left heart.

Unusual fracture in a Durata lead with shock coil fragmentation and cable externalization Toshiaki Sato, MD, Kyoko Soejima, MD, Hideaki Yoshino, MD,

Nanostim leadless pacemaker system: A longer waiting period after active fixation may reduce unnecessary repositioning Hiro Kawata, MD, PhD, Pranav M.

Inappropriate shocks by subcutaneous implantable cardioverter-defibrillator due to T- wave oversensing in hyperkalemia leading to ventricular fibrillation

Cardiac implantable electronic device malfunction after deceleration injury without obvious chest trauma Amr F. Barakat, MD, Brian Cross, MD, Jonathan.

Ventricular tachycardia slower than the rate cut-off of a subcutaneous cardiac defibrillator sensed and successfully treated as a result of oversensing

Mobile subcutaneous implantable cardioverter-defibrillator leads to oversensing and inappropriate shocks Omid Kiamanesh, MD, Jacob M. Larsen, MD, PhD,

Orthostatic increase in defibrillation threshold leading to defibrillation failure and prolonged cardiac arrest in a sitting position: Lessons from a.

T-wave oversensing during left ventricular pacing causing inappropriate defibrillation Joshua Payne, MD, MPH, Sandeep Gautam, MD, MPH, FHRS, Richard Weachter,

Substernal subcutaneous implantable cardioverter-defibrillator lead placement for the management of inappropriate shocks Khuyen Do, MD, Chin C. Lee,

Presentation transcript:

Changing place, changing future: Repositioning a subcutaneous implantable cardioverter-defibrillator can resolve inappropriate shocks secondary to myopotential oversensing Paola Berne, MD, Graziana Viola, MD, Giovanni Motta, MD, Nicola Marziliano, BD, PhD, Valerio Carboni, BSN, Gavino Casu, MD HeartRhythm Case Reports Volume 3, Issue 10, Pages 475-478 (October 2017) DOI: 10.1016/j.hrcr.2017.07.009 Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 1 A: Lateral chest radiograph after subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation. B: Electrogram of S-ICD shocks. Noise from myopotential signals (red arrows) with a similar amplitude to that of QRS complexes at a heart rate of ∼90 beats/min (green arrows) leads to the incorrect detection of tachycardia (asterisk) and an inappropriate shock (single circle) that triggers ventricular fibrillation (star), which is appropriately sensed and treated by means of a second S-ICD shock (double circle). HeartRhythm Case Reports 2017 3, 475-478DOI: (10.1016/j.hrcr.2017.07.009) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 2 Device interrogation before system repositioning. The primary vector (1× gain) showed less oversensing but an unstable R-wave amplitude owing to postural movements (intermittently <1 mV). Maneuvers resembling the exercise that caused the inappropriate shock lead to intermittent oversensing (asterisks). Small R-wave amplitudes were also observed in alternate and secondary vectors. HeartRhythm Case Reports 2017 3, 475-478DOI: (10.1016/j.hrcr.2017.07.009) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 3 A: Lateral chest radiograph after system repositioning (can relocation only). B: Device interrogation repeating the maneuvers in the primary vector (gain setting 2×) did not show oversensing; R-wave amplitude remained constantly >1 mV even with postural changes; and there was better 1:1 beat classification (a premature ventricular contraction was also correctly discarded; see the “•” marker). HeartRhythm Case Reports 2017 3, 475-478DOI: (10.1016/j.hrcr.2017.07.009) Copyright © 2017 Heart Rhythm Society Terms and Conditions