The subcutaneous implantable defibrillator (S-ICD) has become an established tool for the prevention of sudden cardiac death. Based on its detection properties, the S-ICD is essentially dependent on correct morphology discrimination of the QRS complex and avoidance of potential T-wave sensing. We report on a patient who experienced multiple inappropriate S-ICD shocks due to T-wave oversensing in the setting of new onset of right bundle branch block. Strategies for the optimisation of the device programming are discussed.
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The subcutaneous implantable defibrillator (S-ICD) has become an established tool for the prevention of sudden cardiac death. Based on its detection properties, the S-ICD is essentially dependent on correct morphology discrimination of the QRS complex and avoidance of potential T-wave sensing. We report on a patient who experienced multiple inappropriate S-ICD shocks due to T-wave oversensing in the setting of new onset of right bundle branch block. Strategies for the optimisation of the device...
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