Double chamber cross-talk, the ultimate double-cross.

Cross-talk is a well-described phenomenon in a dual-chamber cardiovascular implantable electronic device. Far-field ventricular events are more commonly sensed in the atrial channel, the reverse is uncommon, and seeing both at the same time has never been reported. We present a case of double cross-talk in a dual-chamber Medtronic ® implantable cardioverter-defibrillator. In this report, we decipher an unusual device response to the cross-talk and describe the programming changes required to resolve it.