Abstract
Automatic implantable cardioverter defibrillators (ICDs) are designed to detect and terminate ventricular tachyarrhythmias. Ideally, they do so with a high specificity and sensitivity. Actual ICD technology with detection based mainly on rate provides high sensitivity but moderate specificity. This means that ICD therapy can be initiated by rapid supraventricular tachyarrhythmias. These inappropriate therapies consist either of antitachycardia pacing, cardioversion or defibrillation. Antitachycardia pacing for a supraventricular tachycardia can induce ventricular tachyarrhythmias; in the worse case, this can ultimately lead to arrhythmic death [1]. It is recognized by many publications that inappropriate therapy imposes serious limitations to ICD therapy due to the discomfort associated as well as to the possible serious proarrhythmic consequences [2–7, 11].
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Birgersdotter-Green U, Rosenqvist M, Lindemans FW, Rydén L, Radegran K (1992) Hotter documented sudden death in a patient with an implantable defibrillator. PACE 15: 1008–1014
Böcker D, Block M, Isbruch F, Wietholt D, Hammel D, Scheld HH, Borggrefe M, Breithardt G (1993) Comparison of frequency of aggravation of ventricular tachyarrhythmias after implantation of automatic defibrillators using epicardial versus nonthoracotomy lead systems. Am J Cardiol. 71: 1064–1068
Wietholt D, Block M, Isbruch F, Bäcker D, Borggrefe M, Shenasa M, Breithardt G (1993) Clinical experience with antitachycardia pacing and improved detection algorithms in a new implantable cardioverter-defibrillator. Am J Cardiol 21: 885–894
Fromer M, Brachmann J, Block M, Siebels J, Hoffman E, Almendral J, Ohm 0, den Dulk K, Coumel P, Camm AJ, Touboul P (1992) Efficacy of automatic multimodal device therapy for ventricular tachyarrhythmias as delivered by a new implantable pacing cardioverter-defibrillator. Results of a European multicenter study incorporating 102 implants. Circulation 86: 363–374
Fromer M, Schläpfer J, Fischer A, Kappenberger L (1991) Experience with a new implantable Pacer-, Cardioverter-, Defibrillator for the therapy of recurrent sustained ventricular tachyarrhythmias: a step toward a universal tachyarrhythmia control device. PACE 14: 1288–1298
Grimm W, Flores BF, Marchlinski FE (1992) Electrocardiographically documented unnecessary, spontaneous shocks in 241 patients with implantable cardioverterdefibrillators. PACE 15: 1667–1673
Johnson NJ, Marchlinski FE (1991) Arrhythmias induced by device antitachycardia therapy due to diagnostic nonspecificity. J Am Coll Cardiol 18: 1418–1425
A task force of the working groups on cardiac arrhythmias and cardiac pacing of the European Society of Cardiology (1992) Guidelines for the use of implantable cardioverter defibrillators. Eur Heart J 13: 1304–1310
Lehmann MH, Saksena S (1991) Implantable cardioverter defibrillators in cardiovascular practice: report of the policy conference of the North American Society of Pacing and Electrophysiology. PACE 14: 969–979
Olson WH (1997) Sensing and detection of ventricular tachyarrhythmias by the ICD. In: Allessie MA, Fromer M (eds) Atrial and ventricular fibrillation: mechanisms and device therapy. Futura, Armonk NY pp 399–415
Wietholt D, Block M, Isbruch F, Bäcker D, Borggrefe M, Shenasa M, Breithardt G (1993) Clinical experience with antitachycardia pacing and improved detection algorithms in a new implantable cardioverter-defibrillator. Am J Cardiol 21: 885–894
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1998 Springer-Verlag Italia
About this chapter
Cite this chapter
Fromer, M. (1998). Is QRS Duration a Reliable Parameter in Discriminating between Supraventricular and Ventricular Arrhythmias?. In: Raviele, A. (eds) Cardiac Arrhythmias 1997. Springer, Milano. https://doi.org/10.1007/978-88-470-2288-1_71
Download citation
DOI: https://doi.org/10.1007/978-88-470-2288-1_71
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-2290-4
Online ISBN: 978-88-470-2288-1
eBook Packages: Springer Book Archive