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Inappropriate Defibrillator Therapies: Do Dual-chamber Devices Really Provide a Remedy?

  • T. Kurita
  • K. Satomi
  • A. Taguchi
  • W. Shimizu
  • K. Suyama
  • N. Aihara
  • S. Kamakura
  • K. Niwaya
  • J. Kobayashi
Conference paper

Abstract

Inappropriate shock therapy from an implantable cardioverter defibrillator (ICD) is very painful for patients and may lead to a poor quality of life (QOL) and/or proarrhythmic effects. Excessively aggressive and specific programming of the ICD detection parameters with the aim of avoiding inappropriate therapy may result in a loss of its sensitivity (and in the worst case even to fatal underdetection of VF). Both sensitivity and specificity of the ICD’s diagnostic functions are expected to be improved by atrial sensing, which provides a more complex algorithm for arrhythmia detection based on both ventricular and atrial activity [1–3]. On the other hand, the addition of an atrial lead may produce several adverse effects, such as extension of the operating time, higher risk of lead dislodgement, cardiac tamponade, and occlusion of the subclavian vein.

Keywords

Cardiac Tamponade Sinus Tachycardia Implantable Cardioverter Defibrillator Therapy Implantable Cardioverter Defibrillator Implantation Inappropriate Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Deisenhofer I, Kolb C, Ndrepepa G et al (2001) Do current dual chamber cardioverter defibrillators have advantages over conventional single chamber cardioverter defi-brillators in reducing inappropriate therapies? A randomized, prospective study. J Cardiovasc Electrophysiol 12:134–142PubMedCrossRefGoogle Scholar
  2. 2.
    Wilkoff BL, Kuhlkamp V, Volosin K et al (2001) Critical analysis of dual-chamber implantable cardioverter-defibrillator arrhythmia detection: results and technical considerations. Circulation 103:381–386PubMedCrossRefGoogle Scholar
  3. 3.
    Kuhlkamp V, Wilkoff BL, Brown AB et al (2002) Experience with a dual chamber implantable defibrillator. Pacing Clin Electrophysiol 25:1041–1048PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2004

Authors and Affiliations

  • T. Kurita
    • 1
  • K. Satomi
    • 1
  • A. Taguchi
    • 1
  • W. Shimizu
    • 1
  • K. Suyama
    • 1
  • N. Aihara
    • 1
  • S. Kamakura
    • 1
  • K. Niwaya
    • 2
  • J. Kobayashi
    • 2
  1. 1.Division of CardiologyNational Cardiovascular CenterOsakaJapan
  2. 2.Division of Cardiovascular SurgeryNational Cardiovascular CenterOsakaJapan

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