Literature DB >> 25609903

Authors reply to 'strategies for overcoming T-wave oversensing'.

Becker Sn Alzand1, Tje Phlips1, Rik Willems1.   

Abstract

Entities:  

Keywords:  T-Wave Oversensing

Year:  2014        PMID: 25609903      PMCID: PMC4286958          DOI: 10.1016/s0972-6292(16)30824-5

Source DB:  PubMed          Journal:  Indian Pacing Electrophysiol J        ISSN: 0972-6292


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In their letter to the editor Cay et al [1] express some valid concerns regarding the strategy we described for overcoming T-wave oversensing in our patient [2]. They stress that programmable features of the device should be used first before planning a reintervention. As mentioned in our case-report we tried both the enhanced T wave suppression algorithm available in the device and programming a low sensitivity of 0.9 mv but T-wave oversensing remained. They also stated that changing ventricular sensing configuration can result in higher R-wave amplitude (>3 mV) and loss of T-wave sensing. Changing ventricular sensing configuration is an option in pacemakers (bipolar to unipolar) and some ICDs (true bipolar to integrated bipolar) but unfortunately this option was not available in the device used in our patient. Another suggestion was to change the timing and sequence of ventricular pacing with various V-V pace delay settings to solve the problem of TWOS. Changing the initially chosen optimal V-V interval is often not a practical solution as it might lead to broader QRS complex and loss of optimal synchronization leading to LV function deterioration. The last possible solution they suggest was to increase therapy zones to high ranges and detection intervals to prevent delivery of inappropriate therapies. As they also stated this is inappropriate as the V-V interval during T wave oversensing were about 220 ms. Finally they proposed to perform repositioning of the defibrillator lead before implanting a new lead, but as they realize this it is a more complex procedure. We thank them for their correction of our figures.
  2 in total

1.  Left and Right Ventricle Leads Switch as a Solution for TWave Oversensing - How a Good Idea Turned Out Bad.

Authors:  Bsn Alzand; Tje Phlips; R Willems
Journal:  Indian Pacing Electrophysiol J       Date:  2014-05-25

2.  Strategies for overcoming T-wave oversensing.

Authors:  Serkan Cay; Ozcan Ozeke; Firat Ozcan
Journal:  Indian Pacing Electrophysiol J       Date:  2014-12-15
  2 in total

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