A case of biventricular pacing with a spike on T-wave caused by the algorithm maintaining biventricular pacing rate

Cardiac-resynchronization therapy (CRT) improves the cardiac function of patients with left ventricular (LV) dyssynchrony. Maintenance of the biventricular pacing rate is very important in managing the hemodynamics in patients implanted with CRT devices. A low biventricular pacing rate, for example,...

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Main Authors: Manabu Fujimoto, Tatsunori Ikeda, Masayuki Tuchida, Kouichirou Kontani, Masaru Kiyama, Yasukazu Okeie, Masakazu Yamamoto
Format: Article
Language:English
Published: Wiley 2012-02-01
Series:Journal of Arrhythmia
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1880427612000099
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author Manabu Fujimoto
Tatsunori Ikeda
Masayuki Tuchida
Kouichirou Kontani
Masaru Kiyama
Yasukazu Okeie
Masakazu Yamamoto
author_facet Manabu Fujimoto
Tatsunori Ikeda
Masayuki Tuchida
Kouichirou Kontani
Masaru Kiyama
Yasukazu Okeie
Masakazu Yamamoto
author_sort Manabu Fujimoto
collection DOAJ
description Cardiac-resynchronization therapy (CRT) improves the cardiac function of patients with left ventricular (LV) dyssynchrony. Maintenance of the biventricular pacing rate is very important in managing the hemodynamics in patients implanted with CRT devices. A low biventricular pacing rate, for example, in cases with atrial fibrillation or rapid intrinsic atrioventricular (AV) conduction, decreases the benefits of CRT. The LUMAX HF-T 540 device series (BIOTRONIK, Berlin, Germany) has a LV-triggered pace algorithm, which allows biventicular pacing rates to be maintained even during rapid intrinsic rhythms caused by shortened AV conduction and/or premature ventricular contraction (PVC) occurring in the right ventricle. We encountered a case of CRT device implantation with a defibrillator wherein this triggered pace algorithm caused a spike on T-wave due to T-wave oversensing. By remote monitoring, we were also able to determine that the T-wave oversensing was due to a PVC. The LUMAX 540 series allows for changes in the sensing threshold and filter settings of the device, which facilitated the elimination of T-wave oversensing in this case.
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spelling doaj.art-dd245751f71744459ed39e67fc54a91d2022-12-21T22:50:58ZengWileyJournal of Arrhythmia1880-42762012-02-01281566010.1016/j.joa.2012.02.008A case of biventricular pacing with a spike on T-wave caused by the algorithm maintaining biventricular pacing rateManabu FujimotoTatsunori IkedaMasayuki TuchidaKouichirou KontaniMasaru KiyamaYasukazu OkeieMasakazu YamamotoCardiac-resynchronization therapy (CRT) improves the cardiac function of patients with left ventricular (LV) dyssynchrony. Maintenance of the biventricular pacing rate is very important in managing the hemodynamics in patients implanted with CRT devices. A low biventricular pacing rate, for example, in cases with atrial fibrillation or rapid intrinsic atrioventricular (AV) conduction, decreases the benefits of CRT. The LUMAX HF-T 540 device series (BIOTRONIK, Berlin, Germany) has a LV-triggered pace algorithm, which allows biventicular pacing rates to be maintained even during rapid intrinsic rhythms caused by shortened AV conduction and/or premature ventricular contraction (PVC) occurring in the right ventricle. We encountered a case of CRT device implantation with a defibrillator wherein this triggered pace algorithm caused a spike on T-wave due to T-wave oversensing. By remote monitoring, we were also able to determine that the T-wave oversensing was due to a PVC. The LUMAX 540 series allows for changes in the sensing threshold and filter settings of the device, which facilitated the elimination of T-wave oversensing in this case.http://www.sciencedirect.com/science/article/pii/S1880427612000099Cardiac resynchronization therapyT-wave oversensingSensing threshold
spellingShingle Manabu Fujimoto
Tatsunori Ikeda
Masayuki Tuchida
Kouichirou Kontani
Masaru Kiyama
Yasukazu Okeie
Masakazu Yamamoto
A case of biventricular pacing with a spike on T-wave caused by the algorithm maintaining biventricular pacing rate
Journal of Arrhythmia
Cardiac resynchronization therapy
T-wave oversensing
Sensing threshold
title A case of biventricular pacing with a spike on T-wave caused by the algorithm maintaining biventricular pacing rate
title_full A case of biventricular pacing with a spike on T-wave caused by the algorithm maintaining biventricular pacing rate
title_fullStr A case of biventricular pacing with a spike on T-wave caused by the algorithm maintaining biventricular pacing rate
title_full_unstemmed A case of biventricular pacing with a spike on T-wave caused by the algorithm maintaining biventricular pacing rate
title_short A case of biventricular pacing with a spike on T-wave caused by the algorithm maintaining biventricular pacing rate
title_sort case of biventricular pacing with a spike on t wave caused by the algorithm maintaining biventricular pacing rate
topic Cardiac resynchronization therapy
T-wave oversensing
Sensing threshold
url http://www.sciencedirect.com/science/article/pii/S1880427612000099
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