Abstract
Patient OG, 62 years, with arrhythmogenic cardiomyopathy in the right ventricle and low-tolerated sustained tachycardia, user of an implantable ventricular single-chamber cardiovascular defibrillator (ICD), returned asymptomatic for routine evaluation. Th ere was no registry of sustained arrhythmia, and the limits of stimulation and sensitivity were checked and were appropriate. However, facing the device’s telemetry, it was detected lack of sensitivity in a ventricular extra-systole.
Highlights
This way, facing the possibility that this flaw could generate failure of detection of a slow ventricular tachycardia (Fig. 3), the level of sensitivity regarding implantable ventricular single-chamber cardiovascular defibrillator (ICD) was improved, with the correction of the failure in the extra-systole intermittent sensitivity
The ICDs, differently from pacemakers that posse fixed programming, present a sensitivity gain, called SenseAbilityTM (Fig. 4) in the Abbott generators, whose purpose is to avoid failure of the sensitivity of quick and low amplitude ventricular events. The beginning of this sensitivity curve improves, called decay delay (Fig. 5) in the Abbott generators, and the speed of the sensitivity improvement, called threshold start (Fig. 6) in the Abbott generators, have a goal to avoid excessive sensitivity in T-waves, which would promote an inappropriate detection of a fake ventricular tachycardia
In this case, the programmed sensitivity improvement was promoting a failure of the ventricular sensitivity, which was corrected with the modification in the threshold start to 50% and the decay delay to 0 ms (Fig. 7)
Summary
Patient OG, 62 years, with arrhythmogenic cardiomyopathy in the right ventricle and low-tolerated sustained tachycardia, user of an implantable ventricular single-chamber cardiovascular defibrillator (ICD), returned asymptomatic for routine evaluation. There was no registry of sustained arrhythmia, and the limits of stimulation and sensitivity were checked and were appropriate (Fig. 1). Facing the device’s telemetry, it was detected lack of sensitivity in a ventricular extra-systole (Fig. 2). This way, facing the possibility that this flaw could generate failure of detection of a slow ventricular tachycardia (Fig. 3), the level of sensitivity regarding ICD was improved, with the correction of the failure in the extra-systole intermittent sensitivity
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