S-9
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Management of detection problems
using advanced sensing programming
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Leandro Chiodi, Antonio Fazi,
Michele Maltese*, Stefano Zanoni*, Rossano Vergassola.
Dipartimento di Cardiologia, Osp. S.M. Annunziata, Florence, *Seda S.p.A., Trezzano s/N
(MI), Italy
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Abstract
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Sensing and detection problems in implantable
cardioverter defibrillator (ICD) may cause inappropriate therapies or delay in delivering
therapy. Inappropriate shocks cause physical discomfort for the patient and could
precipitate potentially life-threatening arrhythmias. All currently available devices
include a system for automatic sensing adjustment, with adaptation of both sensitivity and
timing parameters, that allows a reliable detection of ventricular events. In general no
sensitivity programming is required for most clinical application and sensing input stage
parameters are not programmable in most ICDs present in the market. Furthermore the
algorithm for the automatic sensing adjustment is rather complex and some errors could
occur. The long-term intracardiac electrogram (IEGM) memory of the newest ICD generation
is useful to evaluate unusual sensing or detection failures. Biotronik ICD Phylax gives
the possibility to modify the automatic sensing adjustment program and offers a long-term
IEGM memory. In this review we report how unusual sensing and detection failures stored in
the internal IEGM memory of the ICD were corrected by reprogramming the Automatic Sensing
Input Stage parameters using a Biotronik model Phylax ICD.
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Key Words
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Implantable cardioverter defibrillator –
function, indications
automatic sensitivity programming, sensing circuitry, automatic sensitivity control, R
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