ICD discrimination of SVT versus VT with 1:1 V-A conduction: A review of the literature |
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Authors: | Rhanderson N Cardoso Chris Healy Juan Viles-Gonzalez James O Coffey |
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Institution: | Cardiovascular Division, Department of Medicine, University of Miami, Miller School of Medicine, Miami, USA |
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Abstract: | Inappropriate ICD shocks are associated with increased mortality. They also impair patients'' quality of life, increase hospitalizations, and raise health-care costs. Nearly 80% of inappropriate ICD shocks are caused by supraventricular tachycardia. Here we report the case of a patient who received a single-lead dual-chamber sensing ICD for primary prevention of sudden cardiac death and experienced inappropriate ICD shocks. V-A time, electrogram morphology, and response to antitachycardia pacing suggested atrioventricular nodal reentry tachycardia, which was confirmed in an electrophysiology study. Inspired by this case, we performed a literature review to discuss mechanisms for discrimination of supraventricular tachycardia with 1:1 A:V relationship from ventricular tachycardia with 1:1 retrograde conduction. |
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Keywords: | Implantable cardioverter defibrillator Supraventricular tachycardia Atrioventricular nodal reentrant tachycardia Inappropriate shock Rhythm discrimination algorithms |
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